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Percutaneous endoscopic gastrostomy tube

Paolo Orlandoni, Nikolina Jukic Peladic, Mirko Di Rosa, Claudia Venturini, Donata Fagnani, Debora Sparvoli, Natascia Giorgini, Redenta Basile, Claudia Cola
BACKGROUND AND AIMS: European and international guidelines advice against initiating tube-feeding in patients with severe dementia. These recommendations are based on studies with important methodological limitations that evaluated the benefits of artificial nutrition in patients with percutaneous endoscopic gastrostomy almost exclusively in terms of the prolongation of survival. The aims of this study were to assess the harmful effects of home enteral nutrition administered via the nasogastric tube and percutaneous endoscopic gastrostomy in patients with advanced dementia in terms of mechanical, gastrointestinal and metabolic complications, to estimate the survival, to explore the risk factors for mortality and to compare the outcomes of patients with advanced dementia with those of patients without dementia...
July 20, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Balasubramanian Karthikumar, Shyamkumar N Keshava, Vinu Moses, George K Chiramel, Munawwar Ahmed, Suraj Mammen
Background: Interventional radiology (IR) has played an important role in the technical evolution of gastrostomy, from the first surgical, endoscopical to percutaneous interventional procedures. Aim: This study is done to assess the technical feasibility and outcome of IR-guided percutaneous gastrostomy for patients requiring nutritional support for neuromuscular disorders or head and neck malignancies, as well as to describe simplified and newer technique for pull-type gastrostomy...
April 2018: Indian Journal of Radiology & Imaging
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
Eduardo Aimore Bonin, Paulo Roberto Walter Ferreira, Marcelo de Paula Loureiro, Thais Andrade Costa-Casagrande, Paolo de Oliveira Salvalaggio, Guilherme Francisco Gomes, Rafael William Noda, Christopher John Gostout, Leandro Totti Cavazzola
BACKGROUND: In order to simplify a percutaneous gastrostomy procedure and avoid the need of endoscopy or imaging methods, a novel percutaneous magnetically guided gastrostomy (PMG) technique was conceived. The aim of the present study is to evaluate the feasibility of a novel PMG technique with no endoscopy or any imaging guidance in a porcine model. METHODS: Fourteen crossbred domestic pigs were used for prototype development (cadaveric experiments) and proof-of concept, survival study...
July 18, 2018: Surgical Endoscopy
Young Lee, Gregory Zielinski, Jasmine Bhinder, Sandeep Sirsi, Armand Asarian
Gastrostomy tubes can be used to provide long-term nutrition and feeding when oral intake is not adequate. A rare but serious complication includes iatrogenic small bowel injury. The incidence of this is infrequent due to its position of the small bowel beneath the omentum, however, injury leading to obstruction and volvulus has been previously described in the literature. We present an unusual case of gastrostomy tube transection into omental fat causing a kink in the small bowel allowing for a transition point of obstruction and subsequent erosion of the gastrostomy tube into the small bowel...
July 2018: Journal of Surgical Case Reports
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
Andrea Volpe, Georgina Malakounides
PURPOSE OF REVIEW: A practical guide to different feeding tubes available for nutritional support in children, focused on indications, placement methods and complications. RECENT FINDINGS: Enteral nutritional support refers to the delivery of nutrition into the gastrointestinal tract distal to the oesophagus. Different feeding tubes are available for exclusive or supplemental nutritional support in children who are unable to independently sustain their own growth, nutritional and hydration status...
July 12, 2018: Current Opinion in Pediatrics
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
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
Lisa M Angotti, Colleen Casey, Ashar Ata, Stefanie Sueda, Yashar Ettekal, Christina Lee, Daniel Bonville, Steven C Stain, Marcel Tafen
Current anesthesia guidelines require tube feed (TF) interruption for at least four hours before tracheostomy. We hypothesized that preprocedural TF interruption is not required before tracheostomy. We developed a protocol allowing continued feeding. Fifty-six patients undergoing tracheostomy with or without percutaneous endoscopic gastrostomy placement were included. Eleven patients underwent tracheostomy without TF interruption (TF group); the remaining 45 patients had TFs held per the existing anesthesia protocol (nil per os group)...
June 1, 2018: American Surgeon
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
Matthew A Kopke, John S Munday, Arnon Gal
A 10-y-old Irish Setter was presented with a history of recurrent episodes of regurgitation and vomiting, with more recent development of tachypnea. Megaesophagus had been diagnosed in the dog 2 y prior to this presentation. A solitary polypoid mass present immediately rostral to the lower esophageal sphincter was biopsied during percutaneous endoscopic gastrostomy tube placement. Barrett esophagus was diagnosed based on the observation of a polypoid mass with intestinal metaplasia that arose from the surrounding esophagus...
June 1, 2018: Journal of Veterinary Diagnostic Investigation
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
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
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