Percutaneous Image-Guided Transesophageal Long Intestinal Tube Placement for Palliative Decompression in Advanced Cancer Patients with Unresectable Malignant Small Bowel Obstruction

Itou, Chihiro; Sone, Miyuki; Sugawara, Shunsuke; Kimura, Shintaro; Onishi, Yasuyuki

doi:10.1007/s00270-023-03457-3

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…3,4,14,17,40,52 Technical challenges in percutaneous endoscopic gastrostomy (PEG) tube placement can be anticipated in the presence of ascites and diffuse peritoneal metastases involving the greater omentum and gastric serosa. 53,54…”

Section: Resultsmentioning

confidence: 99%

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Consensus Guideline for the Management of Malignant Gastrointestinal Obstruction in Patients with Peritoneal Surface Malignancies

Turaga

2024

Preprint

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Background: Malignant gastrointestinal obstruction (MGIO), a frequent complication of peritoneal surface malignancies (PSM), often portends a poor prognosis. The lack of high-quality evidence on optimal management strategies necessitated a national consensus to address this clinical problem. Methods: A clinical management pathway was designed through a Delphi consensus process with national experts in peritoneal disease. Two rounds of voting were conducted to assess agreement levels with pathway blocks. Supporting evidence regarding procedural interventions for MGIO underwent evaluation via a rapid literature review. Results: Of 111 participants responding in the first round, 90 (81%) responded in the second round. Over 90% consensus was achieved in 4/6 and 6/6 pathway blocks during rounds I and II, respectively. Encouraging a multidisciplinary approach, the pathway emphasized early palliative care assessments and iterative goals of care evaluation throughout treatment. Management was delineated based on obstruction acuity, and selection criteria for palliative-intent surgical interventions and stenting were elucidated. Studies demonstrated limited benefits for such interventions in patients with multifocal obstructions, poor performance status, and high-grade and/or high-burden PSMs. In these cases, a recommendation for supportive care or upper GI decompression tube placement was favored. The overall level of evidence was generally low-moderate in existing literature. Conclusion: Given limited evidence, the consensus-driven pathway provides crucial clinical guidance for practitioners dealing with MGIO in PSM patients. There is a need for high-quality prospective evidence in this domain.

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Section: Resultsmentioning

confidence: 99%

“…Percutaneous transesophageal gastrostomy (PTEG) serves as an alternative in cases with ascites and diffuse gastric involvement. 53,54,71,72…”

Section: Resultsmentioning

confidence: 99%

Consensus Guideline for the Management of Malignant Gastrointestinal Obstruction in Patients with Peritoneal Surface Malignancies

Turaga

2024

Preprint

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Commentary on: Percutaneous Image-Guided Transesophageal Long Intestinal Tube Placement for Palliative Decompression in Advanced Cancer Patients with Unresectable Malignant Small Bowel Obstruction

Lorenzo

2023

Cardiovasc Intervent Radiol

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Esophageal Balloon Air Insufflation to Facilitate Percutaneous Transesophageal Gastrostomy under Moderate Sedation

Thukral,

Cline,

Kim

et al. 2024

Journal of Vascular and Interventional Radiology

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Percutaneous Image-Guided Transesophageal Long Intestinal Tube Placement for Palliative Decompression in Advanced Cancer Patients with Unresectable Malignant Small Bowel Obstruction

Cited by 4 publications

References 24 publications

Consensus Guideline for the Management of Malignant Gastrointestinal Obstruction in Patients with Peritoneal Surface Malignancies

Consensus Guideline for the Management of Malignant Gastrointestinal Obstruction in Patients with Peritoneal Surface Malignancies

Commentary on: Percutaneous Image-Guided Transesophageal Long Intestinal Tube Placement for Palliative Decompression in Advanced Cancer Patients with Unresectable Malignant Small Bowel Obstruction

Esophageal Balloon Air Insufflation to Facilitate Percutaneous Transesophageal Gastrostomy under Moderate Sedation

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