Endoscopically assisted percutaneous transesophageal gastrotubing

Murakami, Masato; Nishino, Keiitiro; Takaoka, Yoko; Murakami, S; Mori, Kosuke; Murakami, Bonpei; Azuma, Mizutomo; Tanabe, Satoshi; Kida, Mitsuhiro; Koizumi, Wasaburo

doi:10.1097/meg.0b013e3283614ae1

Cited by 10 publications

(4 citation statements)

References 20 publications

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“…Other major techniques used for gastrostomy include percutaneous endoscopic gastrostomy (PEG) and surgical techniques such as laparoscopic-assisted percutaneous endoscopic gastrostomy (LAPEG) or percutaneous transesophageal gastrostomy (PTEG). 6 A comparison of PEG and surgical gastrostomy outcomes by Bravo et al 7 found no significant differences in mortality, major complications, or minor complications, apart from a subgroup analysis of randomised studies that slightly favoured PEG. Considering the relatively lesser expense of RIG and PEG, LAPEG would be best suited as a second-line approach for patients with unfavourable anatomy and for correction of suboptimal gastrostomy placement, as reported by Lodin et al 8 PTEG plays an important role when patients have contraindications to more standard methods of enteral access, such as massive ascites, peritoneal carcinomatosis, or difficult anatomy due to a hostile abdomen.…”

Section: Discussionmentioning

confidence: 99%

Radiologically inserted gastrostomy complications: A case series

Zhang

Matthews

Wong

et al. 2022

Int J Gastrointest Interv

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Radiologically inserted gastrostomy (RIG) is performed in patients who cannot safely or sufficiently receive oral nutrition; however, postoperative complications are not uncommon. The risk of major complications such as peritonitis, migration, infection, malposition, and bleeding is small but appreciable, although mortality as a direct consequence of gastrostomy placement is rare. In this case series, we describe the major gastrostomy complications (arterial haemorrhage, gastric fluid leak, peritonitis, RIG site infection, ileus and colon perforation) that occurred in four patients at our hospital over a 27-month period in which 152 RIG procedures were performed (an incidence rate of 2.6%). Herein, we describe the gastrostomy procedures, clinical course, and surgical corrections required for these patients before discussing the complication risks for common gastrostomy procedures and potential methods to reduce and prevent such complications.

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Section: Discussionmentioning

confidence: 99%

Radiologically inserted gastrostomy complications: A case series

Zhang

Matthews

Wong

et al. 2022

Int J Gastrointest Interv

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“…This procedure is usually executed with the use of ultrasonography combined with fluoroscopy but can also be performed using ultrasonography with endoscopic assistance. 17 Apart from overcoming some of the contraindications of PEG and possible adverse events from D-PEJ, PTEG may also offer some advantages over standard gastrostomy tube feeding. First of all, because the puncture site (esophagostomy site) is relatively distant from the tip of the inserted feeding tube, it is possible to start enteral feeding immediately after the procedure.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous transesophageal gastro-tubing (PTEG) as an alternative long-term tube feeding procedure when gastrostomy is not feasible

Yoon

Nishihara

2017

Therap Adv Gastroenterol

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Background:Percutaneous transesophageal gastro-tubing (PTEG) is a minimally invasive technique to access the gut via an esophagostomy. However, this procedure is not well known and the literature available is still fairly limited. This observational study was conducted to evaluate our experience using this method as an alternative long-term tube feeding procedure when gastrostomy is not suitable.Methods:A total of 15 patients (10 males and 5 females) who underwent PTEG at our institution from 2012 to 2016 were observed and analyzed in this study.Results:The average age was 80.1 (71–93) years. Underlying conditions that required PTEG were previous gastric resection in 11 patients, left diaphragm disorder in 2 patients, interposing transverse colon between the abdominal wall and anterior gastric wall in 1 patient, and severe gastrostomy site leakage in 1 patient. Tube placement was successful in all patients by approaching the left side of the neck, using a 15 Fr size tube. The mean postoperative length of stay was 22 (8–48) days. Postoperative adverse events included accidental tube dislodgement in three patients, tracheoesophageal fistula in one patient, inferior thyroid artery injury in one patient and thyroid gland mispuncture in one patient. There was no procedure-related mortality nor mortality at 30 days. Eight patients were discharged with some oral intake.Conclusions:PTEG is feasible in patients requiring long-term tube feeding for whom gastrostomy is unsuitable. It is an effective long-term tube feeding procedure and should be offered as a more comfortable alternative to nasogastric tubing.

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“…All of the procedures were performed using similar methods, as have been previously described (2–8), except that we used an esophageal balloon catheter (Boston Scientific, Marlborough, MA, USA) due to the unavailability of an RFB. The location of the cervical esophagus was evaluated by computed tomography (CT) before the procedure.…”

Section: Methodsmentioning

confidence: 99%

“…PTEG was first described by Oishi et al in 1994 for patients without appropriate transabdominal access, and they developed the PTEG kits (Sumitomo Bakelite, Tokyo, Japan) including the needle, guide wire, rupture-free balloon (RFB), 16-Fr peel away sheath, and tubes (1). The RFB is the crucial material for this procedure and most studies regarding PTEG used this kit (2)(3)(4)(5)(6)(7)(8). Unfortunately, the complete PTEG kits are generally not available in most interventional radiology inventories.…”

Section: Introductionmentioning

confidence: 99%

Hydro-dissection assisted puncture of an esophageal balloon for percutaneous transesophageal gastrotubing: early experience concerning the technical feasibility, safety, and efficacy

et al. 2019

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Background Percutaneous transesophageal gastrotubing (PTEG) is an alternative means of access into the stomach when conventional transabdominal gastric access is not possible. Purpose To describe the early clinical experience, technical feasibility, safety, and efficacy of the hydro-dissection assisted puncture of an esophageal balloon used for PTEG. Material and Methods A retrospective review was conducted of six, consecutive patients with feeding problems and who were treated with hydro-dissection assisted puncture of an esophageal balloon for PTEG. Patient baseline characteristics, such as age, sex, co-morbidities, and the underlying condition requiring PTEG, were recorded. The procedure and clinical outcomes of interests, including the route of approach, procedure time (defined as the time interval from the esophageal balloon insertion to the feeding tube placement), adverse events, duration of feeding through PTEG, and the place of discharge were observed. Results The PTEG creation using “hydro-dissection assisted puncture of an esophageal balloon technique” was achieved in all six patients (100% technical success). The mean procedure time was 16.5 min (range = 13–23 min) and the median duration of the feeding days through the PTEG was 87 days (range = 7–361 days). One case of deep neck infection was developed after the procedure and completely resolved by conservative treatment without removing the PTEG. Conclusions The hydro-dissection assisted puncture of an esophageal balloon is a safe and effective technique for PTEG when the commercial PTEG kits are unavailable.

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Endoscopically assisted percutaneous transesophageal gastrotubing

Abstract: Endoscopically assisted PTEG is a feasible, safe, and useful procedure. The use of endoscopy enhances visual information, may increase the safety of the procedure, and allows better confirmation of each step involved, without radiation exposure.

Cited by 10 publications

References 20 publications

Radiologically inserted gastrostomy complications: A case series

Radiologically inserted gastrostomy complications: A case series

Percutaneous transesophageal gastro-tubing (PTEG) as an alternative long-term tube feeding procedure when gastrostomy is not feasible

Hydro-dissection assisted puncture of an esophageal balloon for percutaneous transesophageal gastrotubing: early experience concerning the technical feasibility, safety, and efficacy

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