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Percutaneous endoscopic gastrostomy tube

Shearwood McClelland, Janna Z Andrews, Huma Chaudhry, Sewit Teckie, Anuj Goenka
Although chemoradiotherapy (CRT) has improved disease outcomes in advanced head and neck cancer (aHNC), toxicity remains a major concern. Treatment interruptions and decreased quality of life (QOL) can occur due to malnutrition, secondary to mucositis, dysphagia and odynophagia. Gastrostomy tubes are used in many patients to improve nutrition during CRT. The optimal timing of PEG placement in patients with aHNC undergoing CRT remains controversial. Using the PubMed database, we performed a systematic review of published CRT series in aHNC to guide decision-making regarding optimal timing of percutaneous endoscopic gastrostomy (PEG) placement...
December 2018: Oral Oncology
Saad Saleem, Wissam Bleibel
A 33-year-old man was admitted to the hospital with upper abdominal pain and melena. Laboratory tests were suggestive of pancreatitis. Computed tomography (CT) of the abdomen showed peripancreatic fat stranding but showed no free air in the peritoneal cavity. Esophagogastroduodenoscopy (EGD) was performed, which revealed an ulcer on the posterior wall of the stomach, caused by the inner tip of the gastrostomy tube, and which had penetrated the pancreas. He had no signs of peritonitis. The gastrostomy tube was exchanged...
July 5, 2018: Curēus
Ayman Goneidy, Georgina Malakounides, Adil Aslam
AIM: Buried Bumper (BB) is a complication of percutaneous endoscopic gastrostomy (PEG) that leads to tube dysfunction and major morbidity. Although many techniques have been described to manage BB, none are universally adopted, and laparotomy remains the mainstay. We introduce a novel endoscopic technique in paediatric surgery that avoids laparotomy. METHODS: A retrospective review of medical records of patients who presented with BB to Cambridge University Hospital, UK, between January 2012 and June 2018 was done...
November 7, 2018: Journal of Pediatric Surgery
Narong Kulvatunyou, Steven A Zimmerman, Moutamn Sadoun, Bellal A Joseph, Randall S Friese, Lynn M Gries, Terence O'Keeffe, Andrew L Tang
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) complications are often under-reported in the literature, especially regarding the incidence of tube dislodgement (TD). TD can cause significant morbidity depending on its timing. We compared outcomes between "push" and "pull" PEGs. We hypothesized that push PEGs, because of its T-fasteners and balloon tip, would have a lower incidence of TD and complications compared with pull PEGs. METHODS: We performed a chart review of our prospectively maintained acute care surgery database for patients who underwent PEG tube placement from July 1, 2009 through June 30, 2013...
December 2018: Journal of Surgical Research
Carmen Molina Villalba, Juan Antonio Vázquez Rodríguez, Francisco Gallardo Sánchez
Percutaneous endoscopic gastrostomy (PEG) is an effective and safe method for nutritional support in patients with malnutrition and impossibility of oral intake with an estimated survival higher than the months that require enteral nutrition beyond four weeks. The main indications include neoplasms of the upper air-digestive tract and neurological diseases, with dementia currently considered a controversial indication. Anatomical alterations and infectious diseases are the most frequent contraindications. There are different endoscopic techniques; the most widely used being the "pull" method, with a low mortality...
November 10, 2018: Medicina Clínica
Kara A Rothenberg, Barnard J Palmer, Olajire Idowu, Sunghoon Kim
BACKGROUND: There are various methods to place a gastrostomy tube. We report a laparoscopic method to place a standard percutaneous endoscopic gastrostomy (PEG) tube without the use of endoscopy. METHODS: Laparoscopic magnet-assisted PEG placement was carried out using an orogastric tube attached with a magnet that is used to retrieve the PEG wire that has been percutaneously placed into the stomach. RESULTS: Four pediatric patients (mean age 31 months) underwent a PEG tube placement using the laparoscopic magnet-assisted PEG tube insertion technique during 2017...
November 8, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Luigi Sivero, Donato Alessandro Telesca, Maurizio Gentile, Giovanni Aprea, Guido Massa, Giovanni Cestaro, Michele Danzi, Stefania Sivero, Cesare Formisano
BACKGROUND AND AIMS: Ethical and medico-legal issues reviews of Percutaneous Endoscopic Gastrostomy (PEG) placement in elderly patients is an important topic of international medical literature. PEG is often inappropriately placed in patients with not spontaneous oral feeding intake, cause of unrealistic expectations. We performed a critical review of the literature for placement of PEG in geriatric patients. METHODS: A literature review was performed about the positioning of the PEG in geriatric patients with dementia and severe anorexia...
2018: Annali Italiani di Chirurgia
Vered Hermush, Yitshal Berner, Yael Katz, Yanina Kunin, Irena Krasniansky, Yael Schwartz, Debbie Mimran Nahon, Ana Elizariev, Gad Mendelson
Background: The use of gastrostomy tubes for long-term nutritional support in older patients is frequent. Percutaneous gastrostomy tube placement may be performed using various techniques, including endoscopic, surgical, and radiologically-guided methods. While percutaneous endoscopic gastrostomy (PEG) placement is the most widely used and accepted approach, experience with the use of percutaneous radiological gastrostomy (PRG) is more limited. Objective: To evaluate the safety and short-term outcomes of PRG in older patients requiring long-term enteral feeding...
2018: Frontiers in Medicine
Nicholas E Bruns, Ian C Glenn, Domenic R Craner, Steve J Schomisch, Michael R Harrison, Todd A Ponsky
BACKGROUND: Magnetic compression anastomosis (magnamosis) is the process of forming a sutureless anastomosis of the gastrointestinal tract using two magnetic Harrison rings. It has been shown to be effective in stomach, small bowel and colon, but has not been implemented in the esophagus. A pure esophageal atresia porcine model was developed to test the concept. METHODS: Five pigs weighing between 35 and 65 kg were used. In all pigs, a percutaneous endoscopic gastrostomy (PEG) tube was placed, and a right thoracotomy was performed...
September 29, 2018: Journal of Pediatric Surgery
Filip Sandberg, Margrét Brands Viktorsdóttir, Martin Salö, Pernilla Stenström, Einar Arnbjörnsson
PURPOSE: A meta-analysis was performed to compare the rates of the major complications associated with two gastrostomy tube placement techniques in a pediatric population: laparoscopy-assisted gastrostomy (LAG) and percutaneous endoscopic gastrostomy (PEG). METHODS: The PubMed electronic database was queried for comparative studies of the two insertion techniques. The Newcastle-Ottawa scale (NOS) was used for the assessment of the quality and risk of bias in the included studies...
December 2018: Pediatric Surgery International
Adam L Jones
This case study presents a patient who has undergone right carotid endarterectomy complicated by glossopharyngeal nerve (or cranial nerve (CN) IX) injury. The patient had one transient ischaemic attack (TIA) three weeks before admission. A computed tomography (CT) scan two days after admission illustrated a right-sided parietal infarct. The patient subsequently had a CT angiogram, which showed a large, calcified plaque in the right internal carotid artery. He then underwent a right carotid endarterectomy...
July 25, 2018: Curēus
Mohamad Hasif Jaafar, Sanjiv Mahadeva, Kit Mun Tan, Ai-Vyrn Chin, Shahrul B Kamaruzzaman, Hui Min Khor, Nor Izzati Saedon, Maw Pin Tan
BACKGROUND: A barrier to gastrostomy feeding exists among Asian clinicians and caregivers due to negative perceptions regarding complications. We compared clinical and nutrition outcomes in older dysphagic Asian patients with nasogastric (NG) or gastrostomy tube feeding using a pragmatic study design. METHODS: The choice of enteral tube access was determined by managing clinicians and patients/caregivers. Comparisons of tube feeding methods were made during a 4-month period, adjusting statistically for inherent confounders...
September 25, 2018: Nutrition in Clinical Practice
Erik Folch, Fayez Kheir, Amit Mahajan, Daniel Alape, Omar Ibrahim, Eugene Shostak, Adnan Majid
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tube placement is a procedure frequently done in the intensive care unit. The use of a traditional endoscope can be difficult in cases of esophageal stenosis and theoretically confers an increased risk of infection due to its complex architecture. We describe a technique using the bronchoscope, which allows navigation through stenotic esophageal lesions and also minimizes the risk of endoscopy-associated infections. METHODS: Prospective series of patients who had PEG tube placement guided by a bronchoscope...
September 24, 2018: Journal of Intensive Care Medicine
Valentina Decimi, Barbara Parma, Roberto Panceri, Chiara Fossati, Milena Mariani, Silvia Russo, Cristina C Gervasini, Maurizio Cheli, Anna Cereda, Angelo Selicorni
Cornelia de Lange syndrome (CdLS) is a genetic condition characterized by intellectual disability, peculiar facial dysmorphisms, multiorgan malformations, and growth problems. Majority cases of CdLS are caused by mutations in genes of Cohesin pathway. Although feeding problems are a well-known feature, no specific data have been published about the use of nutritional devices. We analyzed use, type, time of introduction, and duration of nutritional devices in 73 CdLS patients. In total, 29/73 (40%) used a device; nasogastric tube (NGT) in 28/73 (38%) and percutaneous endoscopic gastrostomy (PEG) in 7/73 (10%)...
September 2018: American Journal of Medical Genetics. Part A
Dan Isaac Cohen-Addad, Kevin Hewitt, Donnie Bell
We report a case of a ventriculoperitoneal shunt incidentally found within the stomach while the patient was undergoing a percutaneous endoscopic gastrostomy (PEG) tube placement. Among the complications of ventriculoperitoneal shunt placement, bowel perforation is rare a complication found in 0.01%-0.07% of cases, and typically occurs in premature infants and neonates [1]. To date, less than 100 such cases have been recorded of which only a few have appeared in the radiological literature. Here we discuss the current literature, the radiological features, clinical presentations and the management...
December 2018: Radiology Case Reports
Anna Wiernicka, Małgorzata Matuszczyk, Agnieszka Szlagatys-Sidorkiewicz, Piotr Landowski, Ewa Toporowska-Kowalska, Beata Gębora-Kowalska, Katarzyna Popińska, Marta Sibilska, Urszula Grzybowska-Chlebowczyk, Sabina Więcek, Ewa Hapyn, Karolina Blimke-Kozieł, Jarosław Kierkuś
BACKGROUND & AIMS: We assessed the tolerability and safety of implementing early enteral nutrition in children at 3 h after percutaneous endoscopic gastrostomy (PEG) placement to establish an optimum feeding mode in paediatric patients that reduced the fasting period, the inadequate nutritional support interval, and the hospitalisation time. METHODS: Children with clinical indications for PEG placement were recruited from six medical centres in Poland to participate in the study...
August 28, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Kah Poh Loh, Maya Abdallah, Meng-Shiou Shieh, Mihaela S Stefan, Penelope S Pekow, Peter K Lindenauer, Supriya G Mohile, Dilip Babu, Tara Lagu
Background: Invasive mechanical ventilation (IMV), dialysis for acute kidney failure, and other critical care therapies (CCTs) are associated with a high risk for complications in patients with metastatic cancer. Inpatient palliative care (IPC) can assist in assessing patients' preferences for life-prolonging treatment at the end of life. This study investigated the use pattern of IPC, outcomes (in-hospital mortality, length of stay [LOS], discharge destination, and cost of care), and predictors of IPC use in patients with metastatic cancer who received CCTs...
September 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Michio Maruyama, Shohei Iijima, Nobuya Ishibashi, Michio Inukai, Tetsuharu Oriishi, Naruo Kawasaki, Naomi Kurata, Yutaka Suzuki, Isao Tabei, Masahiro Chiba, Etsuko Nakamura, Takashi Higashiguchi
BACKGROUND/AIMS: The current study was undertaken to assess if the semi-solid formulas could be used with a new ENFit connector with similar force to current percutaneous endoscopic gastrostomy (PEG) tubes. METHODS: Experiment 1: We measured the applied pressure (force) needed to compress the syringe containing 7 viscous semi-solid formulas with a 20 Fr PEG tube and low-profile tube through the ENFit connector or the current connector. Experiment 2: This experiment was conducted to evaluate the compression force through 2 connectors in 3 infusion velocity, 7 PEG tube types with 2 semi-solid formulas...
2018: Annals of Nutrition & Metabolism
Julie Gallagher
RATIONALE: Pathophysiologic mechanisms of the central nervous system, such as stroke, can be associated with intractable hiccups. Intractable hiccups can be associated with potentially fatal consequences, thus requiring safe management in an inpatient rehabilitation facility (IRF) setting with a multidisciplinary team approach to optimize mobility and feeding. PATIENT CONCERNS: A 49-year-old male presented to the emergency department with complaints of vomiting and dizziness...
August 2018: Medicine (Baltimore)
Soo-Kyung Park, Ji Yeon Kim, Seong-Joon Koh, Yoo Jin Lee, Hyun Joo Jang, Soo Jung Park
BACKGROUND: Gastrostomy tube insertion is beneficial to selected patients, and percutaneous endoscopic gastrostomy (PEG) and percutaneous radiological gastrostomy (PRG) are two of the frequently used methods in gastrostomy. This study aimed to investigate the indications and complications of both PEG and PRG. METHODS: This was a retrospective multicenter cohort study. Patients who underwent initial PEG or PRG tube insertion for nutritional purpose between January 2010 and December 2015 at five university hospitals were included in the study...
August 21, 2018: Surgical Endoscopy
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