Gastrostomy tubes: Fundamentals, periprocedural considerations, and best practices

Anand, Ravi; Wangrattanapranee, Peerapol; Kessler, Jonathan; Kidambi, Trilokesh D.; Tabibian, James H.

doi:10.4240/wjgs.v14.i4.286

Cited by 17 publications

(12 citation statements)

References 174 publications

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“…Although the overall surgical duration for both the rectus abdominis and intercostal regions was slightly longer than the 23.8 ± 1.39 minutes reported for PEG by Zhang et al [22], the gastric insu ation duration in this study ranged from 8 to 11 minutes, which clearly exceeded the values reported by Zhang et al [23]. Since the surgical duration is one of the factors of aspiration after tube implantation [24], further improvements in gastric insu ation methods are needed to shorten the surgery. Furthermore, regardless of whether the CPG stoma is located in the rectus abdominis or intercostal region, it serves to deliver nutrition, as in PEG [5], suggesting positive recovery trajectories for the majority of patients.…”

Section: Discussioncontrasting

confidence: 74%

“…The diagnoses included the following: esophageal tumor (173 patients), head and neck tumor (24), esophagobronchial stula (5), amyotrophic lateral sclerosis (12), lung cancer with esophageal obstruction (7), swallowing dysfunction after cerebral infarction (2), and individual cases of hereditary ataxia, esophageal chemical burn, and severe traumatic brain injury causing swallowing dysfunction.…”

Section: Patientsmentioning

confidence: 99%

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Safety and Efficacy of Stoma Site Selection in CT-guided Percutaneous Gastrostomy: A Retrospective Analysis

Chang-ming,

Xiao-mei,

Liu

et al. 2023

Preprint

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Purpose: To compare the safety and efficacy of CPG in the rectus abdominis and intercostal regions. Materials and Methods: This retrospective study included 226 patients who underwent CPG at a single center, with the stoma placed in the rectus abdominis or intercostal region. Surgical outcomes and complications, such as pain and infection within 6 months postoperatively, were recorded. Results: The surgical success rate was 100%, and the all-cause mortality rate within one month was 0%. An intercostal stoma was placed in 56 cases, while a rectus abdominis stoma was placed in 170 cases. The duration of surgery was longer for intercostal stoma placement (37.66 ± 14.63 min) than for rectus abdominis stoma placement (30.26 ± 12.40 min) (p=0.000). At one month postoperatively, the rate of stoma infection was higher in the intercostal group (32.1%) than in the rectus abdominis group (20.6%), but the difference was not significant (P=0.077). No significant difference was observed in the infection rate between the two groups at three or six months postoperatively (P>0.05). Intercostal stoma patients reported higher pain scores during the perioperative period and at one month postoperatively (P=0.000), but pain scores were similar in the two groups at three and six months postoperatively. The perioperative complication rate for intercostal and rectus abdominis surgery was 1.8% and 5.3%, respectively (P=0.464), with no significant difference in the incidence of tube dislodgement (P=0.514). Patient weight was significantly improved at three and six months postoperatively compared to preoperatively (P<0.05). Conclusion: Both rectus abdominis and intercostal stomas show similar levels of safety and efficacy. However, intercostal stomas may result in greater short-term patient discomfort.

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Section: Discussioncontrasting

confidence: 74%

Section: Patientsmentioning

confidence: 99%

Safety and Efficacy of Stoma Site Selection in CT-guided Percutaneous Gastrostomy: A Retrospective Analysis

Chang-ming,

Xiao-mei,

Liu

et al. 2023

Preprint

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“…Placing a G-tube following a VPS increases the risk of infection and shunt malfunction [25]. Due to the increased risk of ascending meningitis, the presence of a VPS is a relative contraindication to gastrostomy placement [26]. However, there are no neurosurgical guidelines on the matter and controversy still surrounds whether the concurrent procedures are contraindicated [24,26,27].…”

Section: Ventriculoperitoneal Shuntmentioning

confidence: 99%

Untitled

2022

BSCR

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Neurologic injury often influences various bodily functions associated with digestion. It is imperative for an individualto obtain proper nutrients to maintain a healthy lifestyle and recover from injury. In this review, we explore variables and methods of enteral tube placement in neurologic injury patients influencing recovery, specifically G-and J-tubes. We will first review the patient population by identifying leading causes for enteral tube placement among both pediatric and adult neurologic patients. We will then discuss the general procedures for placement and safety considerations for specified patient populations. We will explore interventions limiting placement of the G-and J-tubes by focusing on two interventions: ventriculoperitoneal shunt (VPS) and intrathecal baclofen (ITB). Then, we will highlight nutritional enhancers that may influence general treatment. Finally, we discuss proper weaning procedures and effective methods fitting patient needs.

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“…Gastrostomy may be achieved by surgical (open or laparoscopic), endoscopic or radiologic approaches. Definitive data to prove superiority of endoscopic over radiologic approaches are lacking, although some data suggest that percutaneous endoscopic gastrostomy (PEG) may be associated with a lower adverse event rate than radiologic approaches [27]. Thus, the choice of gastrostomy technique is largely dictated by resource availability and operator expertise.…”

Section: Percutaneous Gastrostomymentioning

confidence: 99%

Updates in percutaneous tracheostomy and gastrostomy: should we strive for combined placement during one procedure?

DeMaio

Yarmus

2022

Current Opinion in Pulmonary Medicine

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Purpose of reviewPercutaneous tracheostomy and gastrostomy are minimally invasive procedures among the most common performed in intensive care units. Practices across centres vary considerably, and questions remain about the optimal timing, performance and postoperative care related to these procedures.Recent findingsThe COVID-19 pandemic has triggered a reevaluation of the practice of percutaneous tracheostomy and gastrostomy in the ICU. Combined percutaneous tracheostomy and gastrostomy at the bedside has potential benefits, including improved nutrition, decreased exposure to anaesthetics, decreased patient transport and decreased hospital costs. Percutaneous ultrasound gastrostomy is a novel technique that eliminates the need for an endoscope that may allow intensivists to perform gastrostomy at the bedside.SummaryMultidisciplinary care is essential to the follow up of critically ill patients receiving tracheostomy and gastrostomy. Combined tracheostomy and gastrostomy has numerous potential benefits to patients and hospital systems. Interventional pulmonologists are uniquely qualified to perform both procedures and serve on a tracheostomy and gastrostomy team.

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Gastrostomy tubes: Fundamentals, periprocedural considerations, and best practices

Cited by 17 publications

References 174 publications

Safety and Efficacy of Stoma Site Selection in CT-guided Percutaneous Gastrostomy: A Retrospective Analysis

Safety and Efficacy of Stoma Site Selection in CT-guided Percutaneous Gastrostomy: A Retrospective Analysis

Untitled

Updates in percutaneous tracheostomy and gastrostomy: should we strive for combined placement during one procedure?

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