Gastroenteric fistula complicating percutaneous endoscopic gastrostomy

Patwardhan, Nitin; McHugh, Kieran; Drake, D. P.; Spitz, Lewis

doi:10.1016/j.jpedsurg.2003.12.018

Cited by 46 publications

(45 citation statements)

References 6 publications

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“…The reason for selecting this procedure instead of the percutaneous endoscopic gastrostomy (PEG) [3] was the reported complications following PEG in children [4,5]. The children were postoperatively carefully followed-up.…”

Section: Children and Methodsmentioning

confidence: 99%

Closure after gastrostomy button

Arnbjörnsson

Backman²,

Berglund³

et al. 2005

Ped Surgery Int

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A gastrostomy device is removed from the gastrostoma when no longer needed. The aim of the study was to test the hypothesis of whether it is possible for the surgeon to decide which stoma has to be closed with a gastroraphy and which to leave for a spontaneous closure within a reasonable period of time. Out of a cohort of 321 patients, who had been operated with a video-assisted gastrostomy, we included all the 48 patients having had their gastrostomy button removed. These patients were carefully followed and the closure of the gastrostoma was registered. According to the institutional routine we waited at least 3 months after the removal of the gastrostomy device before suggesting to the child's guardians an operative closure of the stoma. In 26 patients the stoma closed within 3 months, whereas in 22 patients a surgical gastroraphy was performed. We found no differences between the two groups regarding the patients' diagnoses, the duration of the gastrostoma use or patient's age at the time of removal of the gastrostomy device. This study rejected the hypothesis of predictability of the gastrostoma closure. Thus, we recommend a routine expectance after the removal of a gastrostomy device for at least 1 month. If no spontaneous closure occurs, then a gastroraphy should be performed.

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Section: Children and Methodsmentioning

confidence: 99%

Closure after gastrostomy button

Arnbjörnsson

Backman²,

Berglund³

et al. 2005

Ped Surgery Int

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“…It is one of the most common techniques employed by clinicians in cases where patients are unable to feed themselves [24]. Due to the ambiguity of the current procedures significant complications can occur, particularly the laceration of organs such as the colon that are unknowingly present between the abdomen and stomach walls [25], [26]. Although the system may find application in a number of clinical settings (e.g., laparoscopic camera anchoring, tethering of clips etc.…”

Section: Pegmentioning

confidence: 99%

“…Design of the magnetic system presented was performed using incremental finite element analysis using the FEMM 4.2 software [30]. The inner diameter of the working channel was fixed to 8mm based on current PEG tube diameters [26], the maximum height and diameter of the system were fixed to 60mm and 40mm respectively, based on weight and acceptable distance from the abdomen for tools in the working channel. An automated batch simulation was performed varying all other dimensions with different selected magnetic materials to find the most appropriate geometry of the system.…”

Section: A Magnet Designmentioning

confidence: 99%

Electropermanent Magnetic Anchoring for Surgery and Endoscopy

Tugwell

Brennan

O’Shea

et al. 2015

IEEE Trans. Biomed. Eng.

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This article has been accepted for publication in a future issue of this journal, but has not been fully edited. Content may change prior to final publication. Citation information: DOI 10.1109/TBME.2014.2366032, IEEE Transactions on Biomedical Engineering TBME-00722-2014.R2 1Abstract-The use of magnets for anchoring of instrumentation in minimally invasive surgery and endoscopy has become of increased interest in recent years. Permanent magnets have significant advantages over electromagnets for these applications; larger anchoring and retraction force for comparable size and volume without the need for any external power supply. However, permanent magnets represent a potential hazard in the operating field where inadvertent attraction to surgical instrumentation is often undesirable. The current work proposes an interesting hybrid approach which marries the high forces of permanent magnets with the control of electromagnetic technology including the ability to turn the magnet off when necessary. This is achieved through the use of an electropermanent magnet, which is designed for surgical retraction across the abdominal and gastric walls. Our electropermanent magnet, which is hand-held and does not require continuous power, is designed with a centre lumen which may be used for trocar or needle insertion. The device in this application has been demonstrated successfully in the porcine model where coupling between an intraluminal ring magnet and our electropermanent magnet facilitated guided insertion of an 18Fr Tuohy needle for guidewire placement. Subsequent investigations have demonstrated the ability to control the coupling distance of the system alleviating shortcomings with current methods of magnetic coupling due to variation in transabdominal wall thicknesses. With further refinement, the magnet may find application in the anchoring of endoscopic and surgical instrumentation for minimally invasive interventions in the gastrointestinal tract.

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“…A separação do estômago da parede ocorre geralmente durante a substituição por outra sonda/tubo ou por botão; é aconselhável só efetuar a primeira substituição pelo menos oito semanas após a colocação, podendo este intervalo chegar aos seis meses para crianças malnutridas e/ou em corticoterapia. As fístulas gastroentéricas ocorrem em aproximadamente 2-3% dos casos; 26 de forma a evitar a fístula gastrocólica, a insuflação gástrica com perfeita identificação do local da punção gás-trica (através da transiluminação cutânea e da visualização endoscópica da indentação por pressão digital da parede abdominal) é um requisito 'quase' obrigatório. Existem ainda complicações relativamente raras tais como a laceração do esófago e a oclusão intestinal.…”

Section: Gastrostomiasunclassified

Vias para Nutrição Artificial na Criança (I): Acessos Entéricos

Estevão‐Costa

2014

Acta Med Port

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RESUMOO aporte nutricional adequado é crucial na abordagem terapêutica de múltiplos estados mórbidos, o que justifica o recurso frequente e crescente a vias de acesso específicas para nutrição entérica e parentérica. No presente artigo é realizada uma revisão da literatura relevante acerca de indicações, modalidades, eficácia e complicações das vias de acesso entérico na criança. Os fatores a considerar na decisão entre acesso gástrico e acesso pós-pilórico, e entre colocação de sonda nasogástrica e gastrostomia são criteriosamente discutidos. Perante indicação para acesso gástrico de longa duração, a gastrostomia endoscópica percutânea é a técnica mais utilizada dada a sua eficácia e segurança, embora a morbilidade associada não seja desprezível; a colocação de gastrostomia laparoscópica emerge como uma alternativa potencialmente vantajosa. Palavras-chave: Criança; Nutrição Entérica; Intubação Gastrointestinal; Gastrostomia; Jejunostomia; Laparoscopia. ABSTRACTAppropriate nutritional support is crucial in the therapeutic approach of multiple conditions, which justifies the frequent and increasing use of specific access routes for enteral and parenteral nutrition. This article reviews the relevant literature concerning indications, procedures, effectiveness and complications of enteral access routes in children. The decision between gastric and postpyloric access, and between nasogastric tube and gastrostomy is thoroughly discussed. Percutaneous endoscopic gastrostomy is the most commonly used technique when a long-term gastric access is required, given its efficacy and safety although the associated morbidity is not negligible; laparoscopic gastrostomy emerges as a potentially advantageous alternative.

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Gastroenteric fistula complicating percutaneous endoscopic gastrostomy

Cited by 46 publications

References 6 publications

Closure after gastrostomy button

Closure after gastrostomy button

Electropermanent Magnetic Anchoring for Surgery and Endoscopy

Vias para Nutrição Artificial na Criança (I): Acessos Entéricos

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