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PEG tube

Keith Siau, Tom Troth, Elizabeth Gibson, Anita Dhanda, Lauren Robinson, Neil C Fisher
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tubes allow for long-term enteral feeding. Disk-retained PEG tubes may be suitable for long-term usage without planned replacement, but data on longevity are limited. We aimed to assess the rates and predictors of PEG longevity and post-PEG mortality. DESIGN: Single-centred retrospective cohort study of patients with disk-retained (Freka) PEG tubes. METHODS: All patients undergoing PEG between 2010 and 2013 were identified, and retrospective analysis of outcomes until 2017 (median 1062 days) was performed...
July 24, 2018: Postgraduate Medical Journal
Chih-Cheng Tsao, Shih-Yu Lee, Wei-Kuo Chang, Kuen-Tze Lin, Sheng-Der Hsu, Chen-Liang Tsai, Chun-Shu Lin
OBJECTIVES: To investigate whether percutaneous endoscopic gastrostomy (PEG) tube placement is associated with increased risk of gastric cancer. METHODS: We conducted a nationwide population-based retrospective study in Taiwan. Inpatient data from 1997 to 2010 were collected from Taiwan National Health Insurance Research Database. Patients with age less than 20 years; those with histories of PEG before 2000; those with histories of cancers; and those diagnosed with gastric cancer before or within 6 months of the first PEG procedure were excluded...
September 2018: Medical Hypotheses
J Pratt, S Green
BACKGROUND: PEG tubes are inserted for long term enteral feeding and may need to be removed at some point post insertion. A recognized method to remove the PEG is the cut and push method (CP). Some studies have suggested that CP is safe whilst others have reported complications and death. Subsequently the use of CP is not uniform but, if safe, could provide a cost effective, minimally invasive, alternative to gastroscopy. The aim of this study was to locate and critically appraise all publications relevant to CP in adult patients using a systematic approach...
October 2017: Clinical Nutrition ESPEN
Jose Bennell
Buried Bumper Syndrome (BBS) is a rare complication of percutaneous endoscopic gastrostomy (PEG) tubes. Advice in prevention guidelines differ, but locally agreed protocols can be agreed using the existing evidence. Consideration needs to be given as to how tightly a PEG is clipped after insertion to prevent gastric leakage, and how long after the procedure should it be loosened to prevent BBS. The distance a PEG tube is advanced and whether it should be rotated is also important in order to prevent BBS. The locally developed protocols need to include clear instructions for staff and patients and a supportive education programme, alongside clear record keeping...
July 1, 2018: British Journal of Community Nursing
Karoline Pahsini, Sabine Marinschek, Zahra Khan, Berndt Urlesberger, Peter J Scheer, Marguerite Dunitz-Scheer
BACKGROUND: Enteral nutrition support (ENS) is a standard of care in all NICUs. As a result of long-term ENS, tube dependency can develop. Tube dependency is an inability to make the transition from tube to oral feeds despite the absence of medical reasons for ENS and might lead to symptoms like oral aversion and food refusal. This study aims to evaluate the prevalence of prematurity in a large cohort of tube dependent children. METHODS: Prospectively collected data on tube dependent children who participated in a program based on the "Graz Model of tube weaning" from January 2009 to December 2015 was analysed quantitatively...
June 28, 2018: Journal of Neonatal-perinatal Medicine
Simon P Batterham
Enterocutaneous fistulas are a rare occurrence after placement of a PEG tube. The key risk factor for their development is the time the PEG tube is in situ , giving time for the fistula tract to mature. Enterocutaneous fistulae are traditionally treated with parenteral nutrition or surgical management. We present a case of a 69-year-old woman who underwent surgical closure of an enterocutaneous fistula with a fibrin plug. The fistula recurred on post-operative Day 5, and the patient was placed on thickened fluids to increase the viscosity of the fluid exiting the fistula tract...
July 2018: Journal of Surgical Case Reports
Masaya Iwamuro, Yuki Okamoto, Hiromitsu Kanzaki, Seiji Kawano, Shunsuke Tanabe, Hiromasa Yamamoto, Yoshiro Kawahara, Hiroyuki Okada
A 69-year-old Japanese man underwent successful percutaneous endoscopic gastrostomy (PEG) without any intra-procedural adverse event. However, 3 days postoperatively, he presented with melena and bloody discharge from the gastrostomy tube. Computed tomography revealed gastric emphysema, hepatic portal venous gas, portal vein thrombosis, and swelling of the ascending colon. We administered antibiotics and discontinued enteral feeding; this resulted in resolution of gastric emphysema, hepatic portal venous gas, and portal vein thrombosis and an improvement in the swelling of the ascending colon...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Gabriele Roveron, Mario Antonini, Maria Barbierato, Vita Calandrino, Giancarlo Canese, Lucio Fernando Chiurazzi, Gesualdo Coniglio, Gabriele Gentini, Mara Marchetti, Andrea Minucci, Laura Nembrini, Vanessa Neri, Paola Trovato, Francesco Ferrara
Enteral nutrition (EN) is the introduction of nutrients into the gastrointestinal tract through a tube placed in a natural or artificial stoma. Tubes may be passed into the stomach (gastrostomy) or the jejunum (jejunostomy) in patients who cannot obtain adequate nourishing via oral feeding. Following placement, nurses are typically responsible for management of gastrostomy or other enteral tube devices in both the acute and home care settings. This article summarizes guidelines developed for nursing management of percutaneous endoscopic gastrostomy or jejunostomy (PEG/PEJ) and gastrojejunostomy (PEGJ) tubes, developed by the Italian Association of Stoma care Nurses (AIOSS-Associazione Italiana Operatori Sanitari di Stomaterapia) in collaboration with the Italian Association of Endoscopic Operators (ANOTE-Associazione Nazionale Operatori Tecniche Endoscopiche) and the Italian Association of Gastroenterology Nurses and Associates (ANIGEA-Associazione Nazionale Infermieri di Gastroenterologia e Associati)...
July 2018: Journal of Wound, Ostomy, and Continence Nursing
Shannon Niedermeyer, Michael Murn, Philip J Choi
Amyotrophic lateral sclerosis is a progressive neuromuscular disease characterized by both lower motor neuron and upper motor neuron dysfunction. While clinical presentations can vary, there is no cure for ALS and the disease is universally terminal, with most patients dying from respiratory complications. Patients die on average within 3-5 years of diagnosis, unless they choose to undergo tracheostomy, in which case, they may live on average 2 more years. Up to 95% with ALS in the United States choose not to undergo tracheostomy, so management of respiratory failure is aimed at both prolonging survival as well as improving quality of life...
July 7, 2018: Chest
Brian K Yorkgitis, Olubode A Olufajo, Lori A Gurien, Edward Kelly, Ali Salim, Reza Askari
BACKGROUND: Percutaneous endoscopic gastrostomy tubes are a means of providing an alternative enteric route of nutrition. This study sought to identify risk factors for the prolonged need of a percutaneous endoscopic gastronomy tube (≥90 days) in adult trauma patients. METHODS: The trauma database of a level 1 trauma center was queried retrospectively to identify patients who had percutaneous endoscopic gastronomy tubes placed. RESULTS: A total of 9,772 charts were reviewed with 282 patients (2...
July 5, 2018: Surgery
Paolo Cerrone, Michele Marchese, Maria Antonietta Pistoia, Carmine Marini
Continuous duodenal infusion of levodopa/carbidopa intestinal gel (LCIG) is an established treatment to control motor fluctuations in Parkinson's disease. Duodenal infusion allows a steady absorption of the drug in the small bowel, reducing plasmatic fluctuations of levodopa. Some complications may occur during the treatment, often related to intrajejunal percutaneous endoscopic gastrostomy (PEG-J). We report a case of duodenal ulcer associated with a phytobezoar involving the end of jejunal probe, in a patient who underwent PEG-J for LCIG infusion...
June 29, 2018: BMJ Case Reports
Gyu Young Pih, Hee Kyong Na, Ji Yong Ahn, Kee Wook Jung, Do Hoon Kim, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a relatively safe procedure; however, acute and chronic complications of PEG have been reported. We aimed to determine risk factors associated with complications and 30-day mortality after PEG, based on 11 years of experience at a single tertiary hospital. METHODS: In total, 401 patients who underwent first PEG insertion at the Asan Medical Center, Seoul, Korea, between January 2005 and December 2015 were eligible...
June 28, 2018: BMC Gastroenterology
Yasushi Adachi, Kimishige Akino, Masanori Nojima, Ryogo Himori, Takefumi Kikuchi, Hiroaki Mita, Masahiro Nakamura, Hiroyuki Tsukuda, Hiro-O Yamano, Yasushi Sasaki, Yukinari Yoshida, Yasuo Kato, Hiroshi Nakase, Takao Endo
Background: Although percutaneous endoscopic gastrostomy (PEG) is a well-accepted and less invasive method of feeding tube placement in patients with swallowing difficulties, complications and early death after PEG have been reported. Aim: This study aimed to evaluate predictive factors associated with 30-day mortality after PEG, and to assess the utility of nutritional supporting period before PEG in reducing early mortality following PEG. Design: An observational study...
June 23, 2018: QJM: Monthly Journal of the Association of Physicians
Denise Strijbos, Daniel Keszthelyi, Roel M M Bogie, Lennard P L Gilissen, Martin Lacko, Janneke G J Hoeijmakers, Christiaan van der Leij, Rogier de Ridder, Michiel W de Haan, Ad A M Masclee
BACKGROUND: The optimal technique for long-term enteral feeding has not yet been established. Both percutaneous endoscopic gastrostomy (PEG) and percutaneous radiologic gastrostomy (PRG) are widely used. Aim was to extensively review outcomes of PEG and PRG. MATERIALS AND METHODS: A systematic review using Medline, Embase, and Cochrane was performed, using standardized tools for assessing bias. Main outcomes were infectious and tube-related complications, procedure related and 30-day mortality...
June 19, 2018: Journal of Clinical Gastroenterology
Hongyuan Song, Ting Guo, Zichang Zhao, Youheng Wei, Haoyang Luo, Weizong Weng, Rui Zhang, Ming Zhong, Chunying Chen, Jiacan Su, Wei Shen
Pathological angiogenesis is driven by uncontrolled growth of endothelial cells (ECs), which could lead to retinopathy, tumor and rheumatoid arthritis, etc. ECs must experience multiple cell division process to grow, and cytokinesis is the final step. The present study shows that PEGylated GNRs (PEG-GNRs) specifically target ECs cytokinesis process which results in high ratio of binucleated cells, and these binucleated ECs lose the ability to proliferate. Further data show that PEG-GNRs do not induce toxicity in vitro and in vivo...
September 2018: Biomaterials
J E Yap, P Jaiswal, L Ton, R Szynkarek, B M Attar, S Gandhi
WHAT IS KNOWN AND OBJECTIVE: Elbasvir/grazoprevir is an all-oral regimen approved for patients with hepatitis C virus (HCV) genotypes 1 and 4, and in renal insufficiency. However, to date, no data exist on the efficacy of this regimen when it is crushed and administered through a percutaneous endoscopic gastrostomy (PEG) tube. Here, we illustrate the case of a 63-year-old man who is the only known patient with HCV infection in the English literature to have successfully achieved a sustained viral response (SVR) when elbasvir/grazoprevir oral combination was administered through a PEG tube...
June 15, 2018: Journal of Clinical Pharmacy and Therapeutics
Petra Ambrosch, Mireia Gonzalez-Donate, Asita Fazel, Claudia Schmalz, Jürgen Hedderich
Introduction: Transoral laser microsurgery (TLM) is an accepted and effective treatment strategy for supraglottic carcinomas. Early supraglottic carcinoma has excellent outcomes independently of the treatment approach. The role of TLM for the treatment of locally advanced tumors is debated. Particularly, the functional outcomes after TLM have to be proven by functional assessment of large cohorts of patients. This study analyzes the oncologic and functional outcomes after TLM for supraglottic carcinomas...
2018: Frontiers in Oncology
Sawlar Vu, Amanda B Lewis, Brooks Moore
The technique of using percutaneous endoscopic gastrostomy (PEG) for long-term enteral feeding is well established and commonly used. While the technique is relatively safe and simple, the gastrostomy tube itself may deteriorate or malfunction, requiring a replacement tube. We present a case of a 58-year-old woman who was found to have gastric outlet obstruction from the inflated balloon of a Foley catheter being used as a replacement for her PEG tube. This case illustrates a potential complication of using a Foley catheter in place of commercially available gastrostomy tubes...
February 2018: Clinical practice and cases in emergency medicine
Marco Siano, Nadine Jarisch, Markus Joerger, Vittoria Espeli
BACKGROUND/AIM: Recurrent/metastatic head and neck squamous cell cancer (r/mHNSCC) patients often need a percutaneous endoscopic gastrostomy feeding tube (PEG). Among known prognostic factors, PEG could be prognostic as well. PATIENTS AND METHODS: We retrospectively analyzed r/mHNSCC patients referred for systemic treatment. Kaplan-Meier and multivariate cox regression models were applied to assess prognostic impact of PEG. RESULTS: One hunderd and ten patients were identified, 42 had a PEG at treatment start...
June 2018: Anticancer Research
Vibeke Gye, M B Mortensen
The percutaneous endoscopic gastrostomy (PEG) procedure is normally carried out by two doctors. Preliminary experience has suggested that this procedure may be accomplished with the same safety level using one doctor and a specially trained endoscopy nurse. The aim of the study was to assess the immediate outcome and 30 days' procedure-related morbidity following nurse-assisted percutaneous endoscopic gastrostomy (NA-PEG) in an unselected population of adult patients. Retrospective, nonconsecutive analysis of NA-PEG procedures were registered between 2008 and 2014...
May 2018: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
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