Single‐Stage Percutaneous Gastrostomy Button Insertion: A Leap Forward

Griffiths, Mervyn

doi:10.1177/0148607196020003237

Cited by 11 publications

(8 citation statements)

References 4 publications

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“…The success rate of button gastrostomy insertion approaches 90 to 100% as shown by recent papers. [7][8][9][10][11][12] Lyon and coworkers, 8 using interventional radiology techniques, described a 98% technical success rate in de novo placement of button gastrostomy catheters in fresh tracks. Borge and associates reported a 93% success rate when placing button catheters in mature gastrostomy tracts.…”

Section: Resultsmentioning

confidence: 99%

“…Recently, button placement has been reported as a single-step gastrostomy procedure. [4][5][6][7][8] In particular, button gastrostomy tubes are a useful alternative to the traditional gastrostomy tube for the pediatric population 7 and adult patients with neurologic disease. 8 Patients favor its lowprofile design and more aesthetic nature.…”

Section: Button Gastrostomymentioning

confidence: 99%

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New Approaches to Percutaneous Gastrostomy

O'Dowd

Given²,

Lee³

2004

Semin intervent Radiol

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Novel approaches to percutaneous gastrostomy have evolved because of catheter clogging and displacement, which is commonly seen with currently available gastrostomy catheters. Low-profile button gastrostomy catheters, designed to be inserted into mature tracts, have recently been inserted into fresh gastrostomy tracts. Catheter clogging rarely occurs with these low-profile devices. Catheter displacement remains a problem but new buttons can be inserted at the patient's bedside without the need for a return visit to the radiology department. A 90 to 100% success rate has been shown for placement of gastrostomy buttons. Pull-type endoscopic gastrostomy catheters can be placed radiologically using a standard puncture of the stomach and cannulation of the gastroesophageal junction. A guide wire is manipulated up the esophagus and out the mouth. The pull-type gastrostomy catheter is then attached and pulled down through the esophagus and out through the anterior abdominal wall. These catheters have very good retention devices and rarely become dislodged. Catheter clogging is also rarely seen, provided larger devices are used. Radiological placement of percutaneous endoscopic gastrostomy tubes has been termed the ''hybrid method'' and has been shown to be cheaper than endoscopic and other fluoroscopic methods of gastrostomy.

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Section: Resultsmentioning

confidence: 99%

Section: Button Gastrostomymentioning

confidence: 99%

New Approaches to Percutaneous Gastrostomy

O'Dowd

Given²,

Lee³

2004

Semin intervent Radiol

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“…According to Benkov (22), the exuberant granulation tissue results from traumatic removal of the original gastrostomy tube or the traumatic insertion of a button. The authors describing this complication have recommended the use of topical administrations of silver nitrate and only rarely surgical resection of profuse granulation tissue (4,11,23,24).…”

Section: Discussionmentioning

confidence: 99%

Late‐Onset Complications of Percutaneous Endoscopic Gastrostomy in Children

Ségal,

Michaud,

Guimber

et al. 2001

J. pediatr. gastroenterol. nutr.

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PurposeThe aim of this study was to report the late morbidity of percutaneous endoscopic gastrostomy (PEG) in a pediatric population and to identify possible risk factors for complications developing after PEG insertion.MethodsA PEG was placed in 110 children between 1 May 1990 and 1 January 1997 using the pull technique. A retrospective study of late‐onset complications was performed, with a follow‐up period ranging from 1 to 8 years. All the complications occurring more than 6 days after PEG insertion were recorded, except for gastrostomy tube obstruction and accidental tube dislodgement.ResultsThe prevalence of late‐onset complications related to PEG in our patients varied from 3.8 to 4.4 per 10 5 days. The overall rate of late‐onset complications was 44% (48 complications observed in 29 patients [26%]). Seventy‐five percent of the complications appeared during the first 2 years after PEG insertion. Nine different types of complication have been identified: intragastric buried or extruded gastrostomy (n = 24), gastric metaplasia granulation tissue around the site of gastrostomy (n = 8), intragastric pseudotumoral proliferative gastric mucosa (n = 4), intragastric mucosal ulceration (n = 3), cutaneous necrosis (n = 3), cologastric fistula (n = 2), gastrostomy closure delay after tube removal (n = 2), subcostal neuralgia (n = 1), and peritonitis (n = 1). Wilcoxon and chi‐square tests were used to compare the clinical characteristics of the patients and the type of material used in the two populations, with and without complications. No clinical risk factor for the development of complications could be identified. Intragastric buried or extruded gastrostomy appeared more frequently with the use of one type of button than with the use of tubes.ConclusionsThe authors' experience suggests that PEG is associated with significant late morbidity, which is mainly observed within the first 2 years after PEG insertion. However, no risk factor for the development of such complications could be identified.

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“…Further procedures 7 patients with PEG and 2 with PBG had conversion of their gastrostomy to a gastrojejunal feeding tube. Of the remaining 98 PEG patients, 44(45%) had a change of gastrostomy tube (PEG-PEG or PEG-BG) under GA at a median 12 months [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] post-primary procedure.…”

Section: Post-operative Complicationsmentioning

confidence: 99%

Open Primary Button Versus Laparoscopic Percutaneous Endoscopic Gastrostomy

Davidson

Lee

Suresh

et al. 2020

J. pediatr. gastroenterol. nutr.

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Open primary balloon gastrostomy (PBG) presents an potentialalternative to percutaneous endoscopic gastrostomy (PEG) in children as it obviates the need for change under general anaesthetic (GA), however the complication profile of PBGcompared to PEG is not well defined.Previous series comparing the two have been hampered by the two groups not being equivalent.Our paediatric surgical centre has offeredPBG as an alternative PEG since 2014. We used a matched case-control study to compare outcomes forPBG and PEG. MethodsPatients undergoing PBG were used as "cases"and matched 1:3 by age and diagnosis to patients undergoing PEG, demographics and clinical data as "controls". Primary outcome was rate of complications classified according to Clavien-Dindo(I-V). Secondary outcomes included time to feed and length of stay. Non-parametric, categorical analyses and multivariate logistic regression were performed. Data here presented as median [IQR]. ResultsWe included 140 patients (35 PBG:105 PEG). The two groups were comparable for gender, weight at surgery and follow-up duration. Median operative time was longer for PBG (43min ], p<0.001). Multivariate analysis demonstrated a statistically significant, higher incidence of symptomatic granulation tissue was more common in PBG (10(29%) vs 6(6%), p=0.0008), this remained significant on multivariate analysis ], p=0.001), nil other complication remained significant nor was overall complication rate statistically different. ConclusionsPBG and PEG have similar overall complication rates, however PBG appears to have a higher incidence of granulation tissue. This observation must be weighed against the need for further GA which is not insignificant in medically complex children.

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Single‐Stage Percutaneous Gastrostomy Button Insertion: A Leap Forward

Abstract: This technique is safe and avoids the potential morbidity of a second anesthetic in this high-risk group of patients.

Cited by 11 publications

References 4 publications

New Approaches to Percutaneous Gastrostomy

New Approaches to Percutaneous Gastrostomy

Late‐Onset Complications of Percutaneous Endoscopic Gastrostomy in Children

Open Primary Button Versus Laparoscopic Percutaneous Endoscopic Gastrostomy

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