CT fluoroscopy-guided percutaneous gastrostomy with loop gastropexy and peel-away sheath trocar technique in 31 amyotrophic lateral sclerosis patients

Bucourt, Maximilian de; Collettini, Federico; Althoff, Christian E.; Streitparth, Florian; Greupner, Johannes; Hamm, Bernd; Teichgräber, Ulf

doi:10.1258/ar.2011.110662

Cited by 11 publications

(8 citation statements)

References 25 publications

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“…According to the results of Zopf et al, insertion of 9F PEG/PEJ tubes is related to lower complication rates and mortality risk 30 . Similar results concerning major or minor complications were reported by other groups 6 , 31 – 33 . In the literature, the incidence of major PEG complications has been reported at 1%–3% to as high as 9%; the incidence of minor complications is more widely varied, ranging from 16%–50% 34 .…”

Section: Discussionmentioning

confidence: 62%

Computed Tomography–Guided Percutaneous Gastrostomy/Jejunostomy for Feeding and Decompression

et al. 2016

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Section: Discussionmentioning

confidence: 62%

Computed Tomography–Guided Percutaneous Gastrostomy/Jejunostomy for Feeding and Decompression

et al. 2016

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“…Some authors had been reported the method of computed tomography (CT) guidance or CT fluoroscopy-guided percutaneous gastrostomy [ 3 , 5 , 6 ]. In these reports, the patients underwent the insufflation by a nasal tube in the gastric lumen and then finished the gastrostomy by CT guided.…”

Section: Introductionmentioning

confidence: 99%

The important role of whole-process computed tomography guidance for percutaneous gastrostomy in esophageal cancer patients who are unsuitable for or have had unsuccessful attempts with endoscopic and fluoroscopic gastrostomy

Geng,

Zhao,

Yuan

et al. 2024

BMC Gastroenterol

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Purpose To explore the value of clinical application with the whole process computed tomography (CT) guided percutaneous gastrostomy in esophageal tumor patients. Materials and methods A consecutive series of 32 esophageal tumor patients in whom endoscopic gastrostomy or fluoroscopy guided gastrostomy were considered too dangerous or impossible due to the esophagus complete obstruction, complicate esophageal mediastinal fistula, esophageal trachea fistula or severe heart disease. All of the 32 patients were included in this study from 2 medical center and underwent the gastrostomy under whole process CT guided. Results All of the gastrostomy procedure was finished successfully under whole process CT guided and the technical success rate was 100%. The average time for each operation was 27 min. No serious complications occurred and the minor complications occurred in 3 patients, including local infection, severe hyperplasia of granulation tissue and tube dislodgment. There were no procedure related deaths. Conclusion The technical success rate of whole process CT guided percutaneous gastrostomy is high and the complication is low. This technique can be used feasible and effectively in some special patients.

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“…The latter would increase significantly in the case of the real-time CT-fluoro, whereby the interventionalist would have his own hands immediately next to or even in the direct beam path with few possible protective measures. De Bucourt et al calculate the radiation exposure for the radiologist using real-time CT fluoro at 0.6 μSv per 5 s, assuming personal radiation protection clothing and a distance of 50 cm gantry clearance [24]; however no indication is made of the actual required fluoroscopy duration.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Patients’ X-ray Exposure in 146 Percutaneous Radiologic Gastrostomies

Petersen¹,

Reinhardt²,

Fuchs³

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TPurpose Analysis of patient´s X-ray exposure during percutaneous radiologic gastrostomies (PRG) in a larger population. Materials and MethodsData of primary successful PRGprocedures, performed between 2004 and 2015 in 146 patients, were analyzed regarding the exposition to X-ray. Dose-area-product (DAP), dose-length-product (DLP) respectively, and fluoroscopy time (FT) were correlated with the used x-ray systems (Flatpanel Detector (FD) vs. Image Itensifier (BV)) and the necessity for periprocedural placement of a nasogastric tube. Additionally, the effective X-ray dose for PRG placement using fluoroscopy (DL), computed tomography (CT), and cone beam CT (CBCT) was estimated using a conversion factor. ResultsThe median DFP of PRG-placements under fluoroscopy was 163 cGy*cm 2 (flat panel detector systems: 155 cGy*cm 2 ; X-ray image intensifier: 175 cGy*cm 2 ). The median DLZ was 2.2 min. Intraprocedural placement of a naso-or orogastric probe (n = 68) resulted in a significant prolongation of the median DLZ to 2.5 min versus 2 min in patients with an already existing probe. In addition, dose values were analyzed in smaller samples of patients in which the PRG was placed under CBCT (n = 7, median DFP = 2635 cGy*cm 2 ), or using CT (n = 4, median DLP = 657 mGy*cm). Estimates of the median DFP and DLP showed effective doses of 0.3 mSv for DL-assisted placements (flat panel detector 0.3 mSv, X-ray image converter 0.4 mSv), 7.9 mSv using a CBCT -flat detector, and 9.9 mSv using CT. This corresponds to a factor 26 of DL versus CBCT, or a factor 33 of DL versus CT.Conclusion In order to minimize X-ray exposure during PRGprocedures for patients and staff, fluoroscopically-guided interventions should employ flat detector systems with short transmittance sequences in low dose mode and with slow image frequency. Series recordings can be dispensed with. The intraprocedural placement of a naso-or orogastric probe significantly extends FT, but has little effect on the overall dose of the intervention. Due to the significantly higher X-ray exposure, the use of a CBCT as well as PRG-placements using CT should be limited to clinically absolutely necessary exceptions with strict indication. Ergebnisse Das mediane DFP von PRG-Anlagen unter DL lag bei 163 cGy*cm 2 (FD: 155 cGy*cm 2 ; BV: 175 cGy*cm 2 ). Die mediane DLZ betrug 2,2 min. Dabei führte eine intraprozedurale Anlage einer naso-oder orogastralen Sonde (n = 68) zu einer signifikanten Verlängerung der medianen DLZ auf 2,5 min gegenüber 2 min bei Patienten mit bereits liegender Sonde. Zusätzlich wurden Dosiswerte von kleineren Patientengruppen analysiert, bei denen die PRG CBCT-gestützt (n = 7; medianes DFP = 2635 cGy*cm 2 ), oder CT-gestützt (n = 4, medianes DLP = 657 mGy*cm) angelegt wurde. Durch Abschätzungen aus den medianen DFP bzw. DLP ergaben sich effektive Dosen von 0,3 mSv für DL-gestützte Anlagen (FD 0,3 mSv; BV 0,4 mSv), mittels FD mit CBCT 7,9 mSv, und bei PRG-Anlagen im CT eine effektive Dosis von 9,9 mSv. Das entspricht einem Faktor 26 von DL gegenüber ...

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CT fluoroscopy-guided percutaneous gastrostomy with loop gastropexy and peel-away sheath trocar technique in 31 amyotrophic lateral sclerosis patients

Abstract: Initial results suggest that the described technique under CT guidance is feasible and safe and may especially be advantageous in cases where endoscopic gastrostomy and sedation are contraindicated.

Cited by 11 publications

References 25 publications

Computed Tomography–Guided Percutaneous Gastrostomy/Jejunostomy for Feeding and Decompression

Computed Tomography–Guided Percutaneous Gastrostomy/Jejunostomy for Feeding and Decompression

The important role of whole-process computed tomography guidance for percutaneous gastrostomy in esophageal cancer patients who are unsuitable for or have had unsuccessful attempts with endoscopic and fluoroscopic gastrostomy

Analysis of Patients’ X-ray Exposure in 146 Percutaneous Radiologic Gastrostomies

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