Percutaneous gastrostomy placement by intervention radiology: Techniques and outcome

Balasubramanian, Karthikumar; Keshava, Shyamkumar N.; Moses, Vinu; Chiramel, George Koshy; Ahmed, Munawwar; Mammen, Suraj

doi:10.4103/ijri.ijri_393_17

Cited by 17 publications

(8 citation statements)

References 22 publications

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“…It has been demonstrated that there is no survival advantage of having GFTs placed. Periprocedural complications are common, the most common and feared being aspiration pneumonia [ 31 – 34 ]. Others include trans-colonic tube placement and tube dislodgement [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Dysphagia among geriatric trauma patients: A population-based study

2022

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Objective To determine the significance of dysphagia on clinical outcomes of geriatric trauma patients. Methods This is a retrospective population-based study of geriatric trauma patients 65 years and older utilizing the Florida Agency for Health Care Administration dataset from 2010 to 2019. Patients with pre-admission dysphagia were excluded. Multivariable regression was used to create statistical adjustments. Primary outcomes included mortality and the development of dysphagia. Secondary outcomes included length of stay and complications. Subgroup analyses included patients with dementia, patients who received transgastric feeding tubes (GFTs) or tracheostomies, and speech language therapy consultation. Results A total of 52,946 geriatric patients developed dysphagia after admission during a 9-year period out of 1,150,438 geriatric trauma admissions. In general, patients who developed dysphagia had increased mortality, length of stay, and complications. When adjusted for traumatic brain and cervical spine injuries, the addition of mechanical ventilation decreased the mortality odds. This was also observed in the subset of patients with dysphagia who had GFTs placed. Of the three primary risk factors for dysphagia investigated, mechanical ventilation was the most strongly associated with later development of dysphagia and mortality. Conclusion The geriatric trauma population is vulnerable to dysphagia with a large number associated with traumatic brain injury, cervical spine injury, and polytraumatic injuries that lead to mechanical ventilation. Earlier intubation/mechanical ventilation in association with GFTs was found to be associated with decreased inpatient hospital mortality. Tracheostomy placement was shown to be an independent risk factor for the development of dysphagia. The utilization of speech language therapy was found to be inconsistently utilized.

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Section: Discussionmentioning

confidence: 99%

Dysphagia among geriatric trauma patients: A population-based study

2022

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“…The initially described Foley catheters have been demonstrated to have increased morbidity rate due to tube leakage, breakage, migration, proximal small bowel obstruction, and gastric wall penetration whereas gastrostomy buttons (balloon and mushroom types) consist of a low-profile catheter with a feeding hub, designed for mature tracts [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Button Gastrostomy Tubes for Pediatric Patients: A Tertiary Care Center Experience

Haider

Isa

Awadhi

et al. 2020

International Journal of Pediatrics

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Background and Objective. Gastrostomy tube insertion is one of the most common procedures performed as a radical choice to overcome feeding difficulty in children. This study is aimed at describing the replacement of a button tube instead of the long tube for feeding infants and children requiring gastrostomies in a tertiary care hospital. Design and Setting. This retrospective cross-sectional descriptive study was conducted between January 2009 and August 2019 at Salmaniya Medical Complex which is a tertiary health care institute in the Kingdom of Bahrain. Subjects and Methods. Both charts and electronic health records of pediatric patients between the ages of 0 and 14 years were reviewed. Data were collected including age, sex, nationality, diagnosis, surgical information (procedure center and procedure performed), complications, and follow-up. Results. Out of 34 patients who underwent gastrostomy tube insertion, 30 patients had their long tube replaced by a button gastrostomy. Majority were males (N=18, 60%). Prolonged nasogastric tube feeding was the main indication of referral (N=17, 56%) followed by feed intolerance (N=6, 17%) and gastroesophageal reflux disease (N=5, 16%). The main underlying diseases at referral were neurological impairment (N=19, 63%) and metabolic disorders (N=4, 13%). There was no significant difference between patients with neurological disorders and other diseases in terms of gender, nationality, or age. Laparotomy with gastrostomy is the main approach used (N=18, 60%). No reported complications of button tubes in 50% of the patients (N=15). Conclusions. Prolonged nasogastric tube feeding is the main indication of referral for gastrostomy tube insertion. Neurological disorders are the main diagnosis for the cases operated upon. Laparotomy with gastrostomy is the procedure of choice at our center. Majority of patients had no reported complications of button tube replacement. These children are likely to benefit from the button tube with fewer complications.

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“…2 However, the current technique requires a gastrostomy tube be left in place for 4 to 6 weeks post-procedure to allow for a mature tract to develop, with the potential for associated complications including gastric leak, infection, and pain. 3 Perclose Proglide (Abbott laboratories, Chicago, Illinois, US) is a suture-mediated vascular closure device routinely used in procedures such as endovascular aortic repair. In this proof of concept animal study, we assess the outcomes and safety of a novel method for percutaneous transgastric duodenal stenting, followed by immediate gastric closure using a vascular closure device, without the need for a gastrostomy tube.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Percutaneous Transgastric Duodenal Stenting and Gastrostomy Repair Using a Vascular Closure Device: Proof of Concept in a Porcine Model

et al. 2021

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Introduction. Gastroduodenal stenting is efficacious and safe in both benign and malignant foregut diseases. Transgastric duodenal stenting has been described and however requires a gastrostomy tube to remain in situ for 4 to 6 weeks post-procedure which can lead to complications. We present a technique for immediate gastric repair using a suture-mediated vascular closure device, without the need for a gastrostomy tube in porcine models. Methods. Percutaneous access into the stomach was achieved using fluoroscopy. Two or 3 Perclose Proglide devices were pre-deployed. The tract was dilated and a wire advanced into the distal duodenum. A 15.5 cm covered enteric stent was delivered through the gastrostomy, deployed and position confirmed. The gastrostomy was closed using Perclose Proglide sutures. Necropsy leak pressure measurement was performed to assess integrity of gastrostomy closure in the porcine models. Results. Two (n = 8) or 3 (n = 2) Perclose Proglide devices were deployed in ten porcine models, with 1 misfire (4.5%). Percutaneous transgastric access and stent delivery was successful in all porcine models. Mean leak pressure in the animals with adequately deployed devices was 219 mmHg (range 172 mmHg–270 mmHg). Conclusion. This study demonstrates percutaneous transgastric duodenal stenting with immediate gastric repair using suture-mediated vascular closure devices is a feasible procedure.

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Percutaneous gastrostomy placement by intervention radiology: Techniques and outcome

Cited by 17 publications

References 22 publications

Dysphagia among geriatric trauma patients: A population-based study

Dysphagia among geriatric trauma patients: A population-based study

Button Gastrostomy Tubes for Pediatric Patients: A Tertiary Care Center Experience

Percutaneous Transgastric Duodenal Stenting and Gastrostomy Repair Using a Vascular Closure Device: Proof of Concept in a Porcine Model

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