Enteral feeding tubes: placement by using fluoroscopy and endoscopy.

Ott, David J.; Mattox, H. E.; Gelfand, David W.; Chen, M. Y. M.; Wc, Wu

doi:10.2214/ajr.157.4.1909832

Cited by 78 publications

(45 citation statements)

References 3 publications

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“…Many studies reported that fluoroscopic guidance in the placement of Nasointestinal feeding tubes had a success rate of >84% (14,15), achieving jejunal positioning in 53%, requires on average 22 min of fluoroscopy room time (16). However, this procedure is not only expensive, but also exposes patients and doctors to varying doses of radiation.…”

Section: Discussionmentioning

confidence: 99%

Application of bronchoscope for the placement of nasoenteric feeding tube in patients with esophagectomy: a novel technique

Cao

Zhang

et al. 2017

J. Thorac. Dis.

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Background: Currently the available techniques for the placement of nasoenteric feeding tube (NET), utilizing transnasal gastroscope are fast and tolerable, which is known as the most popular method. However, lots of hospitals don't have this endoscopic system. Bronchoscope, which is the basic respiratory endoscope, not only has the advantages of transnasal endoscopy, but also is popular in common hospitals. We used oxygen instillation as air supply plant of the bronchoscope, which broke its application limitation in digestive tract. The aim of this study is to evaluate the feasibility and availability of the method of placing NET with the bronchoscope in patients with esophagectomy.Methods: From January 2013 to January 2016, a total of 48 patients with esophagectomy who underwent NET placement with the bronchoscope were included in our study. Information concerning age, gender, as well as background disease of the patients was collected. The success rate, procedure duration, and complications were recorded for each patient. Results:The technique success rate reached 100%, procedure time ranged from 150 to 750 s, with an average time of 257 s. All patients tolerated well under local anesthesia, no complication of epistaxis or perforation occurred. Conclusions:The new technique of placing NET with the bronchoscope is fast, safe, effective, and well tolerated for patients with esophagectomy.

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Section: Discussionmentioning

confidence: 99%

Application of bronchoscope for the placement of nasoenteric feeding tube in patients with esophagectomy: a novel technique

Cao

Zhang

et al. 2017

J. Thorac. Dis.

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“…In our view, food intake can irritate the mucosa at the anastomotic site and aggravate the mediastinal abscess, because the digestive slice can continuously enter the abscess from the fistula. Ott et al [30] had reported a success rate for fluoroscopic placement of 90%, with a tube placed into the jejunum in 53% of patients and placed into the duodenum in 47% of the patients. In the present study, the tubes were placed fluoroscopically in the jejunum in all patients, and the mean procedure time was 30 min.…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopically guided nose tube drainage of mediastinal abscesses in post-operative gastro-oesophageal anastomotic leakage

Guo²,

Chen³

et al. 2012

The British Journal of Radiology

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Objective The aim of this study was to retrospectively evaluate the technical success rates and clinical effectiveness of fluoroscopically guided nose tube drainage of mediastinal abscesses and a nasojejunum feeding tube in post-operative gastro-oesophageal anastomotic leakage (GEAL). Methods From January 2006 to June 2011, 18 cases of post-operative GEAL with mediastinal abscesses after oesophagectomy with intrathoracic oesophagogastric anastomotic procedures for oesophageal and cardiac carcinoma were treated by insertion of a nose drainage tube and nasojejunum feeding tube under fluoroscopic guidance. We evaluated the feasibility of two-tube insertion to facilitate leakage site closure and complete resolution of the abscess, and the patients’ nutritional benefit was also evaluated by checking the serum albumin level between pre- and post-enteral feeding via the feeding tube. Results The two tubes were placed successfully under fluoroscopic guidance in 18 patients (100%). The procedure time for two-tube insertion ranged from 20 to 40 min (mean 30 min). 17 patients (94%) achieved leakage site closure after two-tube insertion and had a good tolerance of two tubes in the nasal cavity. The serum albumin level was significant, increased from pre-enteral feeding (2.49±0.42 g dl−1) to the post-enteral feeding (3.58±0.47 g dl−1) via the feeding tube (p<0.001). The duration of follow-up ranged from 1 to 49 months (mean 19 months). Conclusion The insertion of nose tube drainage and a nasojejunum feeding tube under fluoroscopic guidance is safe, and it provides effective relief from mediastinal abscesses in GEAL after oesophagectomy. Moreover, our findings indicate that two-tube insertion may be used as a selective procedure to treat mediastinal abscesses in post-operative GEAL. Advances in knowledge Directive drainage of mediastinal abscesses in post-operative GEAL may be an effective treatment.

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“…While blind placement of feeding tubes requires calculation of the nose-to-tip distance, with real-time fluoroscopy, the tip of the tube can be monitored while it is propagated distally and until it reaches the target location. Ott et al 22 have reported a technical success rate of 90% with feeding tube during real-time fluoroscopy.…”

Section: Real-time Fluoroscopy For Feeding Tube Placementmentioning

confidence: 99%

“…With the increasing use of nasojejunal tubes, which have been associated with a lower risk of aspiration pneumonitis compared to nasogastric tubes, [22][23][24] imaging guidance is often required in order to place the tip of the feeding tubes beyond the pylorus or even into the proximal jejunum. Fluoroscopy is available in most institutions and is well-suited for such purpose because most commercially available feeding tubes appear radio-opaque on X-ray.…”

Section: Real-time Fluoroscopy For Feeding Tube Placementmentioning

confidence: 99%

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Placement of feeding tubes using fluoroscopy guidance and over-the-wire technique: A technical review

Kim

Shin

2017

Int J Gastrointest Interv

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Nutritional support is essential for improving the outcome in critically ill patients. Enteral nutrition possesses advantages over total parenteral nutrition in that it maintains the physiologic barrier function of the gastrointestinal mucosa. Short-term enteral nutrition can be achieved through transnasal feeding tubes. Traditionally, feeding tubes have been placed at bedside in a blind fashion. However, blind tube placement is unreliable as it may result in improper positioning of the tubes. Numerous complications arising from misplacement have been reported in the literature. A number of modalities may be used in order to improve the accuracy and safety of transnasal feeding tube placement. Fluoroscopy is widely accepted for this purpose. Together with the use of water-soluble contrast media and over-the-wire technique, fluoroscopy-guided placement of nasogastric or nasojejunal feeding tubes offers a higher rate of technical success while decreasing procedure time as well as the incidence of procedure-related complications.

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Enteral feeding tubes: placement by using fluoroscopy and endoscopy.

Abstract: Our results show that fluoroscopic and endoscopic placement of enteral feeding tubes is highly effective. Fluoroscopic time in successful cases is usually less than i5 mm. Endoscopic placement of feeding tubes is successful after fluoroscopic failure. AJR

Cited by 78 publications

References 3 publications

Application of bronchoscope for the placement of nasoenteric feeding tube in patients with esophagectomy: a novel technique

Application of bronchoscope for the placement of nasoenteric feeding tube in patients with esophagectomy: a novel technique

Fluoroscopically guided nose tube drainage of mediastinal abscesses in post-operative gastro-oesophageal anastomotic leakage

Placement of feeding tubes using fluoroscopy guidance and over-the-wire technique: A technical review

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