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Journal articles on the topic 'Gastrostomy/contraindications'
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1
El-Matary, Wael. "Percutaneous Endoscopic Gastrostomy in Children." Canadian Journal of Gastroenterology 22, no. 12 (2008): 993–98. http://dx.doi.org/10.1155/2008/583470.
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Percutaneous endoscopic gastrostomy has been a valuable tool in nutritional rehabilitation since its inception in 1980. Although it was originally described in children, a large sector of the adult population is dependant on it for nutritional support. Percutaneous endoscopic gastrostomy tube insertion is generally a safe procedure. Nevertheless, variable incidence rates of complications have been reported. The present review highlights the up-to-date indications, contraindications and complications of percutaneous endoscopic gastrostomy in children, along with a discussion of issues that need further exploring through future research.
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Heitmiller, Richard F. "Indications and contraindications for percutaneous endoscopic gastrostomy and jejunostomy." Current Opinion in Otolaryngology & Head and Neck Surgery 2 (February 1994): 80–84. http://dx.doi.org/10.1097/00020840-199402000-00017.
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Kandel, Gabor P. "Endoscopic Placement of Feeding Tubes." Canadian Journal of Gastroenterology 4, no. 9 (1990): 616–20. http://dx.doi.org/10.1155/1990/438967.
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It is no exaggeration to say that percutaneous gastrostomy has revolutionized the feeding of disabled patients with intact gastrointestinal tracts. The most common indication is inability to swallow. It is generally best to place a gastrostomy tube early to prevent malnutrition and minimize complications of procedures on poorly nourished tissue. If a patient is expected to live for only weeks to months, nasoenteric feedings are the nutritional route of choice. Contraindications to percutaneous gastrostomy include coagulation disorders, upper gastrointestinal fistulas, intestinal obstruction, varices, peritoneal dialysis, septicemia and esophageal obstruction. Three techniques are described: 'pull,' 'push' and 'introducer.' The most frequently reported complications are wound infection and pneumoperitoneum. Now that multiple methods for successful insertion of endoscopic percutaneous feeding tubes have been described, the literature appears to be concentrating on complications of the various techniques. Nevertheless, compared to the other options available for patients unable to swallow (allowing malnutrition to proceed, tube feeding, surgical gastrostomy, parenteral nutrition), percutaneous gastrostomy is the procedure of choice in virtually all cases if the intestine is functioning.
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Burns, Kevin, and Steven Huang. "Percutaneous Transesophageal Gastric Tubes: Indications, Technique, Safety, Efficacy, and Management." Digestive Disease Interventions 02, no. 01 (March 2018): 072–78. http://dx.doi.org/10.1055/s-0038-1639598.
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AbstractPercutaneous transesophageal gastric (PTEG) tube placement is an alternative method of gastric access for feeding or decompression in patients with contraindications to conventional gastrostomy tube placement such as peritoneal carcinomatosis, gastric wall tumors, ascites, or intervening organs. PTEG tube placement is safe with a high technical success rate and it can be placed with supplies available in most interventional radiology departments using ultrasound and fluoroscopic guidance. PTEG tubes are highly efficacious at reducing symptoms in patients with malignant bowel obstruction as an alternative to long-term nasogastric decompression.
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Donnelly, R., L. Freeman, G. Bruch, J. P. Jeannon, T. Wong, M. McCarthy, M. O’Connell, Frances Calman, and R. Simo. "Airway management in patients undergoing insertion of feeding gastrostomy tubes prior to treatment for head and neck cancer—Contraindications of percutaneous gastrostomy." British Journal of Oral and Maxillofacial Surgery 45, no. 8 (December 2007): e3-e4. http://dx.doi.org/10.1016/j.bjoms.2007.08.014.
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Grigaliūnas, Aurelijus, Nijolė Šileikienė, and Algimantas Stašinskas. "Perkutaninė endoskopinė gastrostomija." Lietuvos chirurgija 2, no. 4 (January 1, 2004): 0. http://dx.doi.org/10.15388/lietchirur.2004.4.2347.
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Aurelijus Grigaliūnas, Nijolė Šileikienė, Algimantas StašinskasVilniaus greitosios pagalbos universitetinė ligoninė,Vilniaus universiteto Bendrosios ir plastinės chirurgijos,ortopedijos, traumatologijos klinikosBendrosios chirurgijos centras,Šiltnamių g. 29, LT-04130 VilniusEl. paštas: nijo@delfi.lt Įvadas / tikslas Pateikti perkutaninės endoskopinės gastrostomijos techniką. Nurodyti šio minimaliai invazinio chirurginio metodo indikacijas ir kontraindikacijas. Išanalizuoti Vilniaus greitosios pagalbos universitetinėje ligoninėje atliktų perkutaninių endoskopinių gastrostomijų komplikacijas ir mirties priežastis. Ligoniai ir metodai Retrospektyviai išnagrinėti atliktų perkutaninių endoskopinių gastrostomijų 34 atvejai. Ligoniams, kuriems buvo rijimo sutrikimų, gastrostomijos atliktos "stumk" ir "trauk" būdais. Rezultatai 1996–2003 metais Vilniaus greitosios pagalbos universitetinėje ligoninėje atliktos 34 perkutaninės endoskopinės gastrostomijos: 24 vyrams ir 10 moterų. Amžiaus vidurkis – 55,6 metų. Komplikacijų buvo 9 (26,4%) ligoniams; 4 (11,8%) ligoniai mirė; 5 (14,7%) ligoniams, iškritus gastrostominiams zondams, atliktos regastrostomijos. Išvados Perkutaninė endoskopinė gastrostomija – minimaliai invazinė chirurginė operacija. Jos atlikimo technika paprasta, lengvai įvaldoma. Tai intervencija, pasižyminti mažu komplikacijų ir mirčių skaičiumi. Reikšminiai žodžiai: perkutaninė endoskopinė gastrostomija, enterinis maitinimas, minimaliai invazinė chirurgija Percutaneous endoscopic gastrostomy Aurelijus Grigaliūnas, Nijolė Šileikienė, Algimantas Stašinskas Background / objective To present the formation technique of percutaneous endoscopic gastrostomy; indications and contraindications of this minimally invasive surgical method. To analyze complications and death rate in patients to whom those gastrostomies were performed at Vilnius University Emergency Hospital. Patients and methods Thirty-four cases of percutaneous endoscopic gastrostomies due to dysphagia were reviewed retrospectively. Percutaneous endoscopic gastrostomy formations were performed by the "push" or "pull" methods. Results Thirty-four percutaneous endoscopic gastrostomies were performed in Vilnius University Emergency Hospital in 1996–2003 for 24 male and 10 female patients, mean age 55.6 years. Complications were observed in 9 (26.4%) cases; four (11.8%) patients died. In 5 (14.7%) cases regastrostomies were performed when the gastrostomic drainage tube fell out. Conclusions Percutaneous endoscopic gastrostomy is a minimally invasive surgical intervention. Its technique is simple, easy to master. This intervention shows a relatively low complication and death rate. Keywords: percutaneous endoscopic gastrostomy, enteral nutrition, minimally invasive surgery
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Ripamonti, Carla, Brett T. Gemlo, Federico Bozzetti, and Franco De Conno. "Role of Enteral Nutrition in Advanced Cancer Patients: Indications and Contraindications of the Different Techniques Employed." Tumori Journal 82, no. 4 (July 1996): 302–8. http://dx.doi.org/10.1177/030089169608200402.
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Over the last 20 years there has been great progress regarding total parenteral nutrition and enteral nutrition for patients who cannot take food by mouth or cannot swallow, or so that controlled feeding can be established in anorexic and malnourished patients. The use and the role of artificial nutrition is still controversial in advanced cancer patients. Such controversies often are due to the fact that these patients have a survival expectancy that varies from one to several months. The present review describes the most frequent techniques used for enteral nutrition (nasoenteral tubes, gastrostomy and jejunostomy), their indications, contraindications and complications, and gives an indication regarding which patients may really benefit from enteral nutrition taking into consideration not only the potential advantages but also the discomfort and distress related to enteral nutrition and the different techniques that are employed.
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Zhu, Yanfei, Liping Shi, Hao Tang, and Guoqing Tao. "Current Considerations in Direct Percutaneous Endoscopic Jejunostomy." Canadian Journal of Gastroenterology 26, no. 2 (2012): 92–96. http://dx.doi.org/10.1155/2012/319843.
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For patients who are unable to meet their nutritional needs orally, enteral feeding via a percutaneous approach has become the mainstay of therapy. However, traditional enteral feeding methods, such as percutaneous endoscopic gastrostomy, may not be viable options for patients with severe gastroparesis or gastric outlet obstruction. Direct percutaneous endoscopic jejunostomy (DPEJ) is an enteral access method that was first described more than 20 years ago and has gained popularity among gastroenterologists. This review discusses the indications for and contraindications to DPEJ, the procedure, the application of DPEJ in specific subsets of patients with gastrointestinal disorders, and presents a brief tabular summary of complications and success rates of DPEJ in case series published since 2000.BACKGROUND: Direct percutaneous endoscopic jejunostomy (DPEJ) is a well-known approach to deliver postpyloric enteral nutritional support to individuals who cannot tolerate gastric feeding. However, it is technically difficult, and some case series have reported significant procedural failure rates. The present article describes current indications, successes and complications of DPEJ placementMETHODS: A MEDLINE database search was performed to identify relevant articles using the key words “direct percutaneous endoscopic jejunostomy”, “percutaneous endoscopic gastrostomy”, and “percutaneous endoscopic gastrostomy with a jejunal extension tube”. Additional articles were identified by a manual search of the references cited in the key articles obtained in the primary search.RESULTS: DPEJ is gradually becoming more common in the treatment of patients who cannot tolerate gastric feeding. Differences in patient selection and technique modifications may contribute to the various success rates reported. Failure is most often due to inadequate transillumination or gastroduodenal obstruction. Currently, there are limited data to evaluate the safety and effectiveness of DPEJ.CONCLUSION: The clinical use of DPEJ is increasing. With appropriate care and expertise, DPEJ may prove to be reliable and safe.
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Lee, Alice, Nancy Kim, Sebastian Cousins, Alex Kim, Heidi Young, and Kathleen Anderson. "A Novel Approach to Palliative Bowel Decompression in Malignant Bowel Obstruction for Patients With Contraindications to Venting Gastrostomy Tube." American Journal of Gastroenterology 112 (October 2017): S1349—S1351. http://dx.doi.org/10.14309/00000434-201710001-02477.
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Spader, Heather S., Robert J. Bollo, Christian A. Bowers, and Jay Riva-Cambrin. "Risk factors for baclofen pump infection in children: a multivariate analysis." Journal of Neurosurgery: Pediatrics 17, no. 6 (June 2016): 756–62. http://dx.doi.org/10.3171/2015.11.peds15421.
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OBJECTIVE Intrathecal baclofen infusion systems to manage severe spasticity and dystonia are associated with higher infection rates in children than in adults. Factors unique to this population, such as poor nutrition and physical limitations for pump placement, have been hypothesized as the reasons for this disparity. The authors assessed potential risk factors for infection in a multivariate analysis. METHODS Patients who underwent implantation of a programmable pump and intrathecal catheter for baclofen infusion at a single center between January 1, 2000, and March 1, 2012, were identified in this retrospective cohort study. The primary end point was infection. Potential risk factors investigated included preoperative (i.e., demographics, body mass index [BMI], gastrostomy tube, tracheostomy, previous spinal fusion), intraoperative (i.e., surgeon, antibiotics, pump size, catheter location), and postoperative (i.e., wound dehiscence, CSF leak, and number of revisions) factors. Univariate analysis was performed, and a multivariate logistic regression model was created to identify independent risk factors for infection. RESULTS A total of 254 patients were evaluated. The overall infection rate was 9.8%. Univariate analysis identified young age, shorter height, lower weight, dehiscence, CSF leak, and number of revisions within 6 months of pump placement as significantly associated with infection. Multivariate analysis identified young age, dehiscence, and number of revisions as independent risk factors for infection. CONCLUSIONS Young age, wound dehiscence, and number of revisions were independent risk factors for infection in this pediatric cohort. A low BMI and the presence of either a gastrostomy or tracheostomy were not associated with infection and may not be contraindications for this procedure.
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McCormack, Michael, and Nabil Tariq. "Endoscopic Feeding Access." Digestive Disease Interventions 02, no. 04 (December 2018): 321–35. http://dx.doi.org/10.1055/s-0038-1675596.
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AbstractThe need for enteral access for nutritional support has become increasingly important. It is estimated up to a third of hospitalized patients will suffer from malnourishment. There is evidence that enteral is preferable over parenteral nutrition for improved outcomes. Various approaches for enteral access exist today including blind placement of enteral catheters, radiographically, and surgically placed catheters. However, the endoscopic approach for enteral access is a well-established, reliable, safe, and quick method of obtaining enteral access. In this review article, we will cover the various endoscopic approaches for enteral access. We believe there is no single best approach for enteral access and that it should be tailored to the individual patient. This article will cover both temporary options such as nasoenteric catheters and more permanent options such as percutaneous endoscopic stomas (gastrostomy, gastrojejunostomy, direct jejunostomy) and describe their techniques, indications, contraindications, and pitfalls. Additionally, with the rise of weight loss surgery, we will cover how to manage the patient with altered gastrointestinal anatomy. Lastly, we will also review difficult post procedure scenarios associated with all of these endoscopic methods for enteral access and how to either prevent or properly manage them.
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Nobleza, Christa O’Hana S., Vinciya Pandian, Ravirasmi Jasti, David H. Wu, Marek A. Mirski, and Romergryko G. Geocadin. "Outcomes of Tracheostomy With Concomitant and Delayed Percutaneous Endoscopic Gastrostomy in the Neuroscience Critical Care Unit." Journal of Intensive Care Medicine 34, no. 10 (July 4, 2017): 835–43. http://dx.doi.org/10.1177/0885066617718492.
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Background:In patients with severe neurologic conditions, percutaneous endoscopic gastrostomy (PEG) is typically performed either alone or with a tracheostomy. The characteristics and outcomes of patients receiving PEG concomitantly with a tracheostomy (CTPEG) and those receiving delayed PEG (DPEG) after a tracheostomy were compared.Methods:Retrospective cohort study in a 24-bed neuroscience critical care unit (NCCU) at a tertiary care hospital. Consecutive patients admitted to the NCCU from April 2007 to July 2013 who underwent percutaneous tracheostomy and gastrostomy by the percutaneous tracheostomy team were included and grouped according to the timing of PEG placement: CTPEG versus DPEG.Results:Of the 290 patients, 234 (81%) received CTPEG. Demographic and clinical characteristics were similar among the 2 groups except for a lower median (interquartile range [IQR]) body mass index (BMI; 27 [22.67-31.60] versus 30.8 [24.55-40.06], P = .017) and lower rate of acute respiratory distress syndrome (3.85% vs 10.71%, P = .048) in the CTPEG cohort. Furthermore, 59% of CTPEG cohort were neurology patients while 63% of DPEG were neurosurgery patients, P = .004. Primary outcomes showed shorter mean NCCU length of stay (LOS; 25 [12] vs 33 [17] days, P < .001) and median hospital LOS (32 [25-43] vs 37 [31-56] days, P = .002) for the CTPEG cohort. Secondary outcomes showed higher predischarge prealbumin levels (15.6 [7.75] vs 11.58 [5.41], P = .021) and lower median overall hospital cost (US$123 860.20 [US$99 024-US$168 713.40] vs US$159 633.50 [US$121 312-US$240 213.10], P = .0003) in the CTPEG group. Anatomic contraindications were the most common reason for DPEG (30%).Conclusions:Among institutions with a tracheostomy team, the practice of tracheostomy with concomitant PEG placement may be considered as feasible as delayed PEG in carefully selected neurocritically ill patients with possible advantages of overall shorter NCCU and hospital LOS, higher predischarge prealbumin, and lower hospital costs. These findings may aid in decisions regarding the timing of PEG placement in the NCCU. Further prospective studies are warranted.
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Rees, Lesley, Vanessa Shaw, Leila Qizalbash, Caroline Anderson, An Desloovere, Laurence Greenbaum, Dieter Haffner, et al. "Delivery of a nutritional prescription by enteral tube feeding in children with chronic kidney disease stages 2–5 and on dialysis—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce." Pediatric Nephrology 36, no. 1 (July 29, 2020): 187–204. http://dx.doi.org/10.1007/s00467-020-04623-2.
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AbstractThe nutritional prescription (whether in the form of food or liquid formulas) may be taken orally when a child has the capacity for spontaneous intake by mouth, but may need to be administered partially or completely by nasogastric tube or gastrostomy device (“enteral tube feeding”). The relative use of each of these methods varies both within and between countries. The Pediatric Renal Nutrition Taskforce (PRNT), an international team of pediatric renal dietitians and pediatric nephrologists, has developed clinical practice recommendations (CPRs) based on evidence where available, or on the expert opinion of the Taskforce members, using a Delphi process to seek consensus from the wider community of experts in the field. We present CPRs for delivery of the nutritional prescription via enteral tube feeding to children with chronic kidney disease stages 2–5 and on dialysis. We address the types of enteral feeding tubes, when they should be used, placement techniques, recommendations and contraindications for their use, and evidence for their effects on growth parameters. Statements with a low grade of evidence, or based on opinion, must be considered and adapted for the individual patient by the treating physician and dietitian according to their clinical judgement. Research recommendations have been suggested. The CPRs will be regularly audited and updated by the PRNT.
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Sheir, Hesham M., Tamer A. Wafa, Abdelrahman Elshafey, and Mohamed Elzohiri. "A simplified laparoscopic-assisted gastrostomy technique: a single center experience." Annals of Pediatric Surgery 16, no. 1 (January 3, 2020). http://dx.doi.org/10.1186/s43159-019-0011-y.
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Abstract Background Although percutaneous endoscopic gastrostomy (PEG) is considered simple and effective, major complications have been reported because of the partly blind placement technique. Laparoscopic gastrostomy was described to overcome most of the problems and the contraindications of PEG. Various modifications have been reported to anchor the stomach to the abdominal wall. This study aims at highlighting a single center experience using a simplified technique for gastrostomy and evaluates its outcome. Results The age of the patients ranged from 7 days to 3 years (mean 11.75 ± 12 months in group A and 16 ± 3 months in group B). The mean body weight at time of gastrostomy was 6.5 ± 4.6 kg in group A and 7.5 ± 2 in group B. The mean operative time was 24.8 ± 4 min in group A and 25 ± 1.6 in group B, ranging from 18 to 31 min. The incidence of gastrostomy-related complications was 20% (three cases) in group A versus 12.5% (one case) among patients included in group B. Yet, this difference was statistically insignificant (p = 0.651). No major complications were reported apart from persistent gastrocutaneous fistula in one out of eight cases followed after removal of the gastrostomy (12.5%). There is no significant difference in the outcome either in neonates or in patients less than 5 kg. Conclusions The described simple technique of laparoscopic-assisted gastrostomy is easy, effective, and with a very low incidence of complications. It is also equally safe in neonates and children less than 5 kg.
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Ryou, Marvin, and Sanjay Salgado. "Endoscopic Techniques for Obtaining Enteral Access." DeckerMed Surgery, November 25, 2018. http://dx.doi.org/10.2310/surg.9055.
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In the absence of contraindications, enteral feeding is recommended for patients who are expected to be intolerant of oral feedings beyond 7 days. Enteral access can be accomplished by a variety of means, including surgical, endoscopic, or radiographic methods. This review focuses on endoscopy-guided options for enteral access. These methods include gastric feeding, which can be accomplished by orogastric, nasogastric, or percutaneous endoscopic gastrostomy tube placement, and postpyloric feeding, accessed through oral or nasal jejunal tubes, percutaneous gastrostomy with a jejunal extension, or direct percutaneous jejunostomy. The indications, techniques, complications, and comparative data of these placement options are outlined, and special clinical considerations (including establishing access in patients with dementia or cirrhosis and those on anticoagulation) are discussed. This review contains 5 figures, 1 table, and 33 references. Key words: direct percutaneous jejunostomy, endoscopy, enteral access in cirrhosis, enteral access in dementia, enteral feeding, enteric access, nasogastric feeding tubes, percutaneous endoscopic gastrojejunostomy tubes, percutaneous endoscopic gastrostomy tubes
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Ryou, Marvin, and Sanjay Salgado. "Endoscopic Techniques for Obtaining Enteral Access." DeckerMed Gastroenterology, Hepatology and Endoscopy, November 1, 2017. http://dx.doi.org/10.2310/gastro.9055.
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In the absence of contraindications, enteral feeding is recommended for patients who are expected to be intolerant of oral feedings beyond 7 days. Enteral access can be accomplished by a variety of means, including surgical, endoscopic, or radiographic methods. This review focuses on endoscopy-guided options for enteral access. These methods include gastric feeding, which can be accomplished by orogastric, nasogastric, or percutaneous endoscopic gastrostomy tube placement, and postpyloric feeding, accessed through oral or nasal jejunal tubes, percutaneous gastrostomy with a jejunal extension, or direct percutaneous jejunostomy. The indications, techniques, complications, and comparative data of these placement options are outlined, and special clinical considerations (including establishing access in patients with dementia or cirrhosis and those on anticoagulation) are discussed. This review contains 5 figures, 1 table, and 33 references. Key words: direct percutaneous jejunostomy, endoscopy, enteral access in cirrhosis, enteral access in dementia, enteral feeding, enteric access, nasogastric feeding tubes, percutaneous endoscopic gastrojejunostomy tubes, percutaneous endoscopic gastrostomy tubes
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Ryou, Marvin, and Sanjay Salgado. "Endoscopic Techniques for Obtaining Enteral Access." DeckerMed Medicine, December 21, 2017. http://dx.doi.org/10.2310/im.9055.
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In the absence of contraindications, enteral feeding is recommended for patients who are expected to be intolerant of oral feedings beyond 7 days. Enteral access can be accomplished by a variety of means, including surgical, endoscopic, or radiographic methods. This review focuses on endoscopy-guided options for enteral access. These methods include gastric feeding, which can be accomplished by orogastric, nasogastric, or percutaneous endoscopic gastrostomy tube placement, and postpyloric feeding, accessed through oral or nasal jejunal tubes, percutaneous gastrostomy with a jejunal extension, or direct percutaneous jejunostomy. The indications, techniques, complications, and comparative data of these placement options are outlined, and special clinical considerations (including establishing access in patients with dementia or cirrhosis and those on anticoagulation) are discussed. This review contains 5 figures, 1 table, and 33 references. Key words: direct percutaneous jejunostomy, endoscopy, enteral access in cirrhosis, enteral access in dementia, enteral feeding, enteric access, nasogastric feeding tubes, percutaneous endoscopic gastrojejunostomy tubes, percutaneous endoscopic gastrostomy tubes
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Mogensen, Kris M., and Malcolm K. Robinson. "Enteral and Parenteral Nutrition." DeckerMed Medicine, May 31, 2017. http://dx.doi.org/10.2310/im.1118.
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Alternative routes of nutrient administration are available for patients who are unable to eat or digest sufficient food to prevent malnutrition. These routes include enteral (administered through the gastrointestinal tract) and parenteral (administered intravenously). This review details the clinical consequences of malnutrition, nutritional assessment, the benefits of nutrition support therapy, determining the nutrient prescription, special considerations in nutrition support therapy, aspects of obtaining enteral or parenteral access, monitoring of patients receiving nutrition support therapy, and complications and ethical issues associated with enteral and parenteral nutrition. Figures include algorithms showing the identification of malnutrition, the nutrition support decision process, and the approach to gastric residual monitoring; nasogastric tube displacement leading to pneumothorax; proper placement of a long or “midline” catheter versus a peripherally inserted central catheter; and photographs of a 43-year-old man with Crohn disease complicated by enterocutaneous fistula formation, distal small bowel obstruction, and evisceration of the small bowel after developing a pelvic abscess. Tables list acute illness- or injury-related malnutrition; chronic disease−related malnutrition; social or environmental circumstances−related malnutrition; indications and contraindications to enteral and parenteral nutrition; selected examples of predictive equations; electrolyte provision in parenteral nutrition; parenteral vitamin and trace element requirements; complications associated with enteral and parenteral nutrition; and indications, contraindications, and complications of gastrostomy tube placement. This review contains 6 highly rendered figures, 11 tables, and 167 references.