Comparison of Gastrostomy Tube Replacement Verification Using Air Insufflation Versus Gastrograffin

Burke, David T.; Shami, Amir El; Heinle, Edward W.; Pina, Burt D.

doi:10.1016/j.apmr.2006.07.266

Cited by 15 publications

(11 citation statements)

References 7 publications

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“…This technique is particularly useful for dilating narrowed stomas and at present is not recommended for routine change of G‐tubes 17 . A Medline search revealed only 1 study that has prospectively compared the different methods to confirm proper placement of G‐tube replacement 18 . Burke et al, 18 in a nonrandomized study, compared air insufflation, followed by plain radiograph assessment, for 19 patients to gastrografin radiocontrast studies for another 17 patients.…”

Section: Discussionmentioning

confidence: 99%

“…A Medline search revealed only 1 study that has prospectively compared the different methods to confirm proper placement of G‐tube replacement 18 . Burke et al, 18 in a nonrandomized study, compared air insufflation, followed by plain radiograph assessment, for 19 patients to gastrografin radiocontrast studies for another 17 patients. All patients had proper tube placement in all replacements and no complications over the subsequent 2 weeks after the replacements.…”

Section: Discussionmentioning

confidence: 99%

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Peritonitis After Gastrostomy Tube Replacement

Taheri

Singh

2010

J Parenter Enteral Nutr

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Background: The placement of feeding gastrostomy (G) tubes through a percutaneous endoscopic gastrostomy (PEG) technique has become common because of its simplicity and safety. The majority of the serious complications are reported to occur within a few days of initial tube placement and happen in fewer than 3% of cases. Long‐term reported complications of this procedure include occlusion or breakage of the G‐tube, requiring reinsertion. This report describes the complication of intraperitoneal placement and the development of peritonitis after replacement of an established PEG tube and reviews the pertinent world literature. Methods: A retrospective review of cases of intraperitoneal insertion of replacement G‐tubes was done as well as a Medline search for cases of intraperitoneal insertion of replacement G‐tube or development of peritonitis after replacement tube insertion. Results: Three new cases of inadvertent intraperitoneal insertion of a replacement G‐tube in adult patients with mature tracts are reported. An additional 5 cases have been previously described in adults. Significant morbidity was associated with this complication, and 4 deaths were related to it. Methods used to determine whether the replacement G‐tube was intragastric were not uniform. Conclusions: There have been few reports of intraperitoneal insertion of replacement G‐tubes in patients with mature (>30 days) stoma sites. The cases presented in this report highlight for the clinician the importance of considering this complication, particularly if there are any difficulties with the reinsertion. Prospective studies are needed to determine the frequency of this complication and the optimal protocol for PEG replacement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Peritonitis After Gastrostomy Tube Replacement

Taheri

Singh

2010

J Parenter Enteral Nutr

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“…In Japan, PEG replacement is often performed in the patient's home or nursing home without EGDor fluoroscopy. Non-endoscopic methods to determine correct catheter placement include insufflation of air, indigocarmine solutions, or ultrasound [19][20][21] . Suzuki et al [20] reported that PEG catheter misplacement was detected at a frequency of 0.4% in 961 patients using indigocarmine solution.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of outpatient percutaneous endoscopic gastrostomy replacement using esophagogastroduodenoscopy and propofol sedation

Horiuchi

Nakayama²,

Kajiyama³

et al. 2012

WJGE

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AIM:To evaluate the effectiveness of outpatient percutaneous endoscopic gastrostomy (PEG) replacement using esophagogastroduodenoscopy (EGD) and propofol sedation. METHODS:We retrospectively assessed the outcome and complications of consecutive patients referred for PEG replacement which was performed using EGD under propofol sedation in the outpatient setting. The success rate, the mean dose of propofol, procedure time, EGD findings, discharge time from endoscopy unit, respiratory depression, and complications within 72 h of the procedure were evaluated. In a subset of these patients, the blood concentrations of propofol were measured. RESULTS:All 221 patients underwent successful PEG replacement. The mean dose of propofol was 34 mg (range, 20-60 mg) with a mean procedure time of 5.9 min (range, 3-8 min). Reflux esophagitis (12 patients), gastric ulcer (5), gastric neoplasm (2), and duodenal ulcer (1) were newly diagnosed at replacement. Discharge from endoscopy unit was possible in 100% of patients 45 min after the procedure. Only 3.6% (8) required transient supplemental oxygen. No complications occurred within 72 h of the procedure. During EGD the level of sedation and propofol blood concentrations after administration of propofol (30 mg) in these PEG patients corresponded to those of propofol (60 mg) in middle aged subjects (control).CONCLUSION: PEG replacement using EGD and propofol sedationin the outpatient setting was safe and practical.

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“…Twenty-nine gastrostomy tubes were replaced using air insufflation and 19 tubes using water-soluble contrast followed by fluoroscopy. At two weeks post-procedure, the authors found no difference between the two techniques in terms of complications or mis-positioned tubes (Burke et al, 2006;Burke & Hoaglin, 2007;Orlando Regional Medical Center Department of Surgical Education, 2009). Peritonitis is a feared complication of PEG that often carries a high mortality rate.…”

Section: Complications Of Percutaneous Endoscopic Gastrostomymentioning

confidence: 99%