Percutaneous endoscopic transgastric jejunostomy (PEG-J): a retrospective analysis on its utility in maintaining enteral nutrition after unsuccessful gastric feeding

Yoon, Ezekiel Wong Toh; Yoneda, Kaori; Nakamura, Shinya; Nishihara, Kazuki

doi:10.1136/bmjgast-2016-000098

Cited by 19 publications

(7 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In critically ill patients, postpyloric enteral feeding not only reduces the risk of pneumonia but also improves the patient’s nutritional status per recently published meta-analyses 15 16. However, studies of the durations of jejunal extension tube groups are sparse 17. The median tube exchange interval of PGJL in our study was longer than that derived by Ridtitid et al 18 while that for PGJM was shorter than the durations calculated by Uflacker et al 19.…”

Section: Discussionsupporting

confidence: 48%

How often should percutaneous gastrostomy feeding tubes be replaced? A single-institute retrospective study

Hyo

Park

Baeg

et al. 2022

BMJ Open Gastroenterol

View full text Add to dashboard Cite

ObjectivePercutaneous gastrostomy (PG) is a common procedure that enables long-term enteral nutrition. However, data on the durability of individual tube types are insufficient. We conducted this study to compare the longevities and features of different PG tube types.DesignWe performed a 5-year retrospective analysis of patients who underwent endoscopic and radiologic PG-related feeding tube procedures. The primary and secondary outcomes were tube exchange intervals and revenue costs, respectively. Demographic factors, underlying diseases, operator expertise, materials used, and complication profiles were assessed.ResultsA total of 599 PG-related procedures for inserting pull-type PG (PGP), balloon-type PG (PGB), PG jejunal MIC* (PGJM; gastrojejunostomy type), and PG jejunal Levin (PGJL) tubes were assessed. On univariate Kaplan-Meier analysis, PGP tubes showed longer median exchange intervals than PGB tubes (405 days (95% CI: 315 to 537) vs 210 days (95% CI: 188 to 238); p<0.001). Larger PGB tubes diameters were associated with longer durations than smaller counterparts (24 Fr: 262 days (95% CI: 201 to NA), 20 Fr: 216 days (95% CI: 189 to 239), and 18 Fr: 148 days (95% CI: 100 to 245)). The PGJL tubes lasted longer than PGJM counterparts (median durations: 168 days (95% CI: 72 to 372) vs 13 days (95% CI: 23 to 65); p<0.001). Multivariate Cox proportional regression analysis revealed that PGJL tubes had significantly lower failure rates than PGJM tubes (OR 2.97 (95% CI: 1.17 to 7.53); p=0.022). PGB tube insertion by general practitioners was the least costly, while PGP tube insertion by endoscopists was 2.9-fold more expensive; endoscopic PGJM tubes were the most expensive at two times the cost of PGJL tubes.ConclusionPGP tubes require replacement less often than PGB tubes, but the latter are more cost-effective. Moreover, PGJL tubes last longer than PGJM counterparts and, owing to lower failure rates, may be more suitable for high-risk patients.

show abstract

Section: Discussionsupporting

confidence: 48%

How often should percutaneous gastrostomy feeding tubes be replaced? A single-institute retrospective study

Hyo

Park

Baeg

et al. 2022

BMJ Open Gastroenterol

View full text Add to dashboard Cite

show abstract

“…PEG‐J, which uses jejunal extension tubes placed through PEG tubes, carries the risk of tube blockage and limited gastric decompression because of the tube size through the PEG. However, these limitations are avoided with the Cliny PEG‐J Catheter as the tube size is larger than that of a jejunal extension tube 8 ; furthermore, its design ensures that there is minimal risk of dislocation or deviation towards the anal side due to its extended length, with the tip placed at the cervical esophagus, making it more convenient to use than other PEG‐J catheters.…”

Section: Discussionmentioning

confidence: 99%

Retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures

Yamashita,

Otsuka,

Goto

et al. 2023

DEN Open

View full text Add to dashboard Cite

Locally advanced esophageal cancer often presents with dysphagia and can be complicated by aspiration pneumonia. Therefore, nutritional management is important to prevent pneumonia. Enteral nutrition via gastrostomies is common in esophageal cancer patients. Here, we describe the efficacy of nutritional management using a gastrojejunostomy tube retrogradely inserted in the esophagus through gastrostomy to simultaneously drain accumulated fluid on the proximal side of a malignant stricture. We performed this procedure for two cases with severe malignant strictures using two types of endoscope insertion. A 57‐year‐old male patient (Case 1) underwent a retrograde insertion of a gastrojejunostomy tube for severe esophageal malignant stricture with severe nausea and salivary reflux. After a narrow endoscope was inserted through the gastrostomy fistula, a gastrojejunostomy tube was inserted alongside a guidewire allowing the patient to undergo definitive chemoradiotherapy without symptoms. An 82‐year‐old male patient (Case 2) was scheduled for a minimally invasive esophagectomy following neoadjuvant chemotherapy after gastrostomy. However, the patient developed aspiration pneumonia due to salivary reflux; before surgery, a narrow nasal endoscope was inserted and passed through the strictures. The percutaneous endoscopic transgastric jejunostomy catheter was retrogradely inserted alongside the guidewire. In patients with malignant strictures and salivary reflux, retrograde insertion of gastrojejunostomy tubes can simultaneously provide enteral nutrition and saliva drainage.

show abstract

“… 13 , 14 Peristomal leakage rate for D-PEJ has also been reported to be higher than PEG and may impede continuous enteral nutrition. 15 , 16 …”

Section: Discussionmentioning

confidence: 99%

Percutaneous transesophageal gastro-tubing (PTEG) as an alternative long-term tube feeding procedure when gastrostomy is not feasible

Yoon

Nishihara

2017

Therap Adv Gastroenterol

Self Cite

View full text Add to dashboard Cite

Background:Percutaneous transesophageal gastro-tubing (PTEG) is a minimally invasive technique to access the gut via an esophagostomy. However, this procedure is not well known and the literature available is still fairly limited. This observational study was conducted to evaluate our experience using this method as an alternative long-term tube feeding procedure when gastrostomy is not suitable.Methods:A total of 15 patients (10 males and 5 females) who underwent PTEG at our institution from 2012 to 2016 were observed and analyzed in this study.Results:The average age was 80.1 (71–93) years. Underlying conditions that required PTEG were previous gastric resection in 11 patients, left diaphragm disorder in 2 patients, interposing transverse colon between the abdominal wall and anterior gastric wall in 1 patient, and severe gastrostomy site leakage in 1 patient. Tube placement was successful in all patients by approaching the left side of the neck, using a 15 Fr size tube. The mean postoperative length of stay was 22 (8–48) days. Postoperative adverse events included accidental tube dislodgement in three patients, tracheoesophageal fistula in one patient, inferior thyroid artery injury in one patient and thyroid gland mispuncture in one patient. There was no procedure-related mortality nor mortality at 30 days. Eight patients were discharged with some oral intake.Conclusions:PTEG is feasible in patients requiring long-term tube feeding for whom gastrostomy is unsuitable. It is an effective long-term tube feeding procedure and should be offered as a more comfortable alternative to nasogastric tubing.

show abstract

Percutaneous endoscopic transgastric jejunostomy (PEG-J): a retrospective analysis on its utility in maintaining enteral nutrition after unsuccessful gastric feeding

Cited by 19 publications

References 22 publications

How often should percutaneous gastrostomy feeding tubes be replaced? A single-institute retrospective study

How often should percutaneous gastrostomy feeding tubes be replaced? A single-institute retrospective study

Retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures

Percutaneous transesophageal gastro-tubing (PTEG) as an alternative long-term tube feeding procedure when gastrostomy is not feasible

Contact Info

Product

Resources

About