A simple method for endoscopic placement of a nasoduodenal feeding tube

Abstract

The key to short-term enteral feeding in patients with gastroparesis is to deliver the nutrition beyond the pylorus. Endoscopic assisted methods allow the precise placement of the feeding tube to the small bowel. However, the main difficulty in association with these procedures is feeding-tube migration into the stomach during the withdrawal of the endoscope. We have developed an endoscopic method with a high success rate which prevents this problem. A reusable angiocatheter guidewire was threaded through the feeding tube, passing beyond the distal opening prior to the withdrawal of the scope. Counterpressure was applied to the feeding tube during the withdrawal of the endoscope. We have successfully placed feeding tubes in 22 out of 23 patients with no complications.

D-Dimer in the Early Diagnosis of Acute Mesenteric Ischemia Secondary to Arterial Occlusion in Rats

“…Other diagnostic parameters investigated in the present study were not as valuable as D-dimer. The only exception was a signifi cant elevation in leukocyte count at 12 h, but its diagnostic value was not signifi cant since bowel necrosis may have developed in 12 h. The low specifi city of leukocytosis was emphasized previously [1,19] .…”

Endoscopically Assisted Nasojejunal Feeding Tube Placement: Technique and Results in Five Dogs

“…11,25 Multiple human and veterinary studies demonstrated the role of endoscopy and fluoroscopy as viable alternatives for the correct and rapid positioning of nasojejunal feeding tubes. 16,17,19,[21][22][23][26][27][28][29][30] Techniques for the fluoroscopic and endoscopic placement of nasojejunal feeding tubes can be classified into three general categories: pull along technique, Seldinger technique, and a push-along technique. 31 In the endoscopically assisted pull along technique, a suture is used to attach the tip of the feeding tube to the tip of the endoscope, which are simultaneously advanced through the pylorus and into the intestines.…”

“…The feeding tube is released and the endoscope withdrawn, leaving the feeding tube positioned within the intestine. 29 In the Seldinger technique, endoscopy or fluoroscopy is used to preplace a guidewire within the intestines. Guidewires are pushed across the pharynx, stomach, and into the pylorus, or are deployed through the biopsy channel of an endoscope that has been positioned within the intestines.…”

Endoscopic feeding tube placement in patients with cancer: a prospective clinical audit of 2055 procedures in 1866 patients

“…There are numerous peer‐reviewed publications describing different endoscopic techniques for feeding tube placements 6,12–16,20–23 . Very few reports have included hundreds of consecutive patients in their studies 24,25 .…”

“…18,19 There are numerous peer-reviewed publications describing different endoscopic techniques for feeding tube placements. 6,[12][13][14][15][16][20][21][22][23] Very few reports have included hundreds of consecutive patients in their studies. 24,25 Most of these reports are by investigators who have developed the techniques or modified it further.…”