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BMJ Open Gastroenterology Jul 2022Percutaneous endoscopic gastrostomy (PEG) was developed by Ponsky-Gauderer in the early 1980s. These tubes are placed through the abdominal wall mainly to administer... (Review)
Review
BACKGROUND
Percutaneous endoscopic gastrostomy (PEG) was developed by Ponsky-Gauderer in the early 1980s. These tubes are placed through the abdominal wall mainly to administer fluids, drugs and/or enteral nutrition but can also be used for drainage or decompression. The tubes consist of an internal and external retention device. It is a generally safe technique but major or minor complications may arise during and after tube placement.
METHOD
A narrative review of the literature investigating minor complications after PEG placement.
RESULTS
This review was written from a clinical viewpoint focusing on prevention and management of minor complications and documented with real cases from more than 21 years of clinical practice.
CONCLUSIONS
Depending on the literature the incidence of minor complications after gastrostomy placement can be high. To decrease associated morbidity, prevention, early recognition and popper management of these complications are important.
Topics: Enteral Nutrition; Gastrostomy
PubMed: 35851280
DOI: 10.1136/bmjgast-2022-000975 -
World Journal of Gastroenterology May 2020Percutaneous endoscopic gastrostomy is an established method to provide nutrition to patients with restricted oral uptake of fluids and calories. Here, we review the... (Review)
Review
Percutaneous endoscopic gastrostomy is an established method to provide nutrition to patients with restricted oral uptake of fluids and calories. Here, we review the methods, indications and complications of this procedure. While gastrostomy can be safely and easily performed during gastroscopy, the right patients and timing for this intervention are not always chosen. Especially in patients with dementia, the indication for and timing of gastrostomies are often improper. In this patient group, clear data for enteral nutrition are lacking; however, some evidence suggests that patients with advanced dementia do not benefit, whereas patients with mild to moderate dementia might benefit from early enteral nutrition. Additionally, other patient groups with temporary or permanent restriction of oral uptake might be a useful target population for early enteral nutrition to maintain mobilization and muscle strength. We plead for a coordinated study program for these patient groups to identify suitable patients and the best timing for tube implantation.
Topics: Enteral Nutrition; Gastroscopy; Gastrostomy; Humans; Patient Selection; Practice Guidelines as Topic; Time Factors; Time-to-Treatment
PubMed: 32523304
DOI: 10.3748/wjg.v26.i20.2464 -
Pediatrics in Review Apr 2024Gastrostomy tube insertion has become a more common practice in pediatric patients. An increasing number of children both in health-care facilities and at home are... (Review)
Review
Gastrostomy tube insertion has become a more common practice in pediatric patients. An increasing number of children both in health-care facilities and at home are relying on temporary or long-term enteral feeding. Gastrostomy tube placement can be accomplished by various methods and by a variety of specialists. Despite the overall safety of these procedures, both early and late complications can occur. It is important for pediatricians and pediatric subspecialists to be familiar with and aware of the indications, safety, and management of gastrostomies. This paper provides a comprehensive overview of the topic.
Topics: Humans; Child; Gastrostomy; Enteral Nutrition
PubMed: 38556513
DOI: 10.1542/pir.2022-005647 -
Endoscopy Mar 2007Radiologic gastrostomy has a higher success rate and a lower complication rate and offers a greater choice of tubes than percutaneous endoscopic gastrostomy (PEG). The... (Review)
Review
Radiologic gastrostomy has a higher success rate and a lower complication rate and offers a greater choice of tubes than percutaneous endoscopic gastrostomy (PEG). The position and configuration of the stomach and colon are clearly seen under fluoroscopy, and ultrasound can be used to locate the liver. Radiologic gastrostomy procedures can be performed when there are oropharyngeal tumors, or esophageal strictures and stents, and can be performed under local anesthesia alone. Peroral push-gastrostomies are preferable for palliative care and for patients with neurogenic dysphagia, but percutaneously inserted tubes should be used in patients with upper gastrointestinal cancers in order to avoid tumor seeding. Unfortunately, awareness of and access to radiologic techniques are still limited and this has led to the development of "adventurous" techniques for placing endoscopes in stomachs rather than applying simple fluoroscopic alternatives.
Topics: Equipment Design; Fluoroscopy; Gastrostomy; Humans; Stomach Diseases; Treatment Outcome
PubMed: 17402168
DOI: 10.1055/s-2006-945119 -
The Surgical Clinics of North America Dec 1992Gastrostomies play an important role in the management of a wide variety of surgical and nonsurgical conditions of childhood. Many techniques and gastrostomy devices are... (Review)
Review
Gastrostomies play an important role in the management of a wide variety of surgical and nonsurgical conditions of childhood. Many techniques and gastrostomy devices are available. In our experience, percutaneous endoscopic gastrostomy has proved safe and effective, and the gastrostomy button has eliminated most of the catheter-related problems. Candidates for gastrostomy, particularly children with foregut dysmotility, must be carefully selected, undergo preoperative studies aimed at determining the degree of gastroesophageal reflux, and have appropriate long-term follow-up. Attention to technical detail is essential to avoid operative complications. A good working relationship between the surgeon, gastroenterologist, nurse, and patient's family is essential to minimize long-term morbidity, particularly stoma-related problems.
Topics: Child; Gastrostomy; Humans; Infant
PubMed: 1440157
DOI: 10.1016/s0039-6109(16)45881-0 -
The Veterinary Clinics of North... May 1993Over the past 5 to 7 years, the veterinary profession has benefitted from our increased ability to provide nutrition to the small animal patient who cannot or will not... (Review)
Review
Over the past 5 to 7 years, the veterinary profession has benefitted from our increased ability to provide nutrition to the small animal patient who cannot or will not eat. The adaptation of the percutaneous endoscopic gastrostomy (PEG) for use in the dog and cat deserves a great deal of credit in advancing the level of care we can now give to the chronically ill or critical care patient. The PEG is a relatively simple technique that has proved to be a very cost-efficient way to maintain the nutritional status of the small animal patient. In the author's experience, owner acceptance of using the PEG in the home environment on a chronic basis has been excellent.
Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Enteral Nutrition; Gastrostomy; Humans; Postoperative Complications
PubMed: 8503158
DOI: 10.1016/s0195-5616(93)50303-0 -
Nutrition in Clinical Practice :... Apr 2023Gastrostomy tubes benefit patients but also introduce hazards and costs. Most of these costs tend to be administratively invisible, but clinically expensive. Nurses,...
Gastrostomy tubes benefit patients but also introduce hazards and costs. Most of these costs tend to be administratively invisible, but clinically expensive. Nurses, residents, emergency physicians, surgeons, and others routinely manage complaints about gastrostomy tubes or sites, and the time and effort costs are enormous. Despite widespread use of gastrostomy tubes and the large "cost of ownership," scant instruction guides practitioners on troubleshooting the panoply of tube-related problems. Instead, clinical folk-wisdom leaves staff disarmed, resorting to lore or maladaptive work-arounds that are futile or even harmful. But tubes and gastrostomies fail in predictable ways. This guide reviews commonly used gastrostomy tubes and how they are placed. Routine care of these tubes both in the immediate postoperative period and long-term is detailed. Then, specific gastrostomy tube complications and their principle-based countermeasures are described, organized by presenting complaint. Throughout, specific clinical pitfalls are called out along with their remedies. The aim is to demystify these devices and dispel myths that lead to error.
Topics: Humans; Child; Gastrostomy; Enteral Nutrition; Intubation, Gastrointestinal; Retrospective Studies
PubMed: 36785522
DOI: 10.1002/ncp.10958 -
European Journal of Radiology Sep 2002Gastrostomy is a preferred method of nutrition in patients with impaired ability to eat. Although surgical gastrostomy is a well-established method and has been widely... (Review)
Review
Gastrostomy is a preferred method of nutrition in patients with impaired ability to eat. Although surgical gastrostomy is a well-established method and has been widely performed in the last century, beginning with early 1980s, percutaneous gastrostomy techniques, either endoscopic or radiologic, has widely gained acceptance. As percutaneous methods have been shown to be an effective, safe, easy to perform and low-cost techniques with low morbidity and mortality rates, nowadays percutaneous gastrostomy is the first method of choice in need of nutrition in patients with functioning gut. In this article authors review the technique of percutaneous radiologic gastrostomy, as well as indications, contraindications, variations of technique, ethical considerations, controversies and comparison with surgical and endoscopic methods.
Topics: Contraindications; Enteral Nutrition; Gastrointestinal Contents; Gastrostomy; Humans; Nutritional Support; Radiography, Abdominal; Radiography, Interventional; Risk Factors
PubMed: 12204401
DOI: 10.1016/s0720-048x(02)00155-9 -
The British Journal of Surgery Aug 1990The many variations of surgical gastrostomy for nutritional support or for long-term gastric decompression all have a significant morbidity and mortality. An... (Comparative Study)
Comparative Study Review
The many variations of surgical gastrostomy for nutritional support or for long-term gastric decompression all have a significant morbidity and mortality. An 'incisionless' technique under local anaesthesia, namely percutaneous endoscopic gastrostomy, was described in 1980. A review of the literature shows that the percutaneous technique is safer for the patient, easier and faster to perform and considerably cheaper than surgical gastrostomy. As the few complications usually require surgical management, percutaneous endoscopic gastrostomy should be considered a surgical technique. Few patients are unsuitable for the percutaneous endoscopic technique and this route should be considered for all patients referred for a gastrostomy.
Topics: Enteral Nutrition; Gastroscopy; Gastrostomy; Humans; Stomach
PubMed: 2118406
DOI: 10.1002/bjs.1800770805 -
Journal of Laparoendoscopic Surgery Aug 1995Percutaneous endoscopic gastrostomy (PEG) is the procedure of choice in the nutritional management of patients requiring gastrostomies. Laparoscopic gastrostomy is... (Comparative Study)
Comparative Study Review
Percutaneous endoscopic gastrostomy (PEG) is the procedure of choice in the nutritional management of patients requiring gastrostomies. Laparoscopic gastrostomy is usually performed when PEG is contraindicated, for example, in patients with esophageal strictures, large gastric tumors, or a history of multiple abdominal surgery. We report herein a case of gasless laparoscopic gastrostomy performed for carcinoma associated with a severe respiratory distress syndrome in a malnourished patient with a tight esophageal stricture. The gasless technique uses the Laparolift System (Laparolift, Origin Medsystem, Inc.), a device composed of a fan-shaped retractor and a mechanical lifting arm that produces an abdominal wall distention resembling a truncated pyramid. Gasless laparoscopy was a safe alternative approach to CO2 pneumoperitoneum in this patient.
Topics: Carbon Dioxide; Carcinoma; Deglutition Disorders; Enteral Nutrition; Esophageal Neoplasms; Esophageal Stenosis; Gastrostomy; Humans; Laparoscopes; Laparoscopy; Male; Middle Aged; Pneumoperitoneum, Artificial
PubMed: 7579678
DOI: 10.1089/lps.1995.5.245