Percutaneous Endoscopic Gastrostomy Research Articles (Page 1)

Background: Nearly four centuries after Lazare Rivière’s first description of infective endocarditis—and over two centuries since septic embolization was recognized—a new epidemic has emerged: infective endocarditis in the era of drug use disorder. Case report: A 36-year-old woman, with drug use disorder was found unconscious with fentanyl and needles nearby. On initial evaluation, she met criteria for systemic inflammatory response syndrome: fever (T 101°F), tachycardia (HR 142 bpm), and hypotension (BP 70/43 mmHg). She was unresponsive to noxious stimuli and had a 15 cm chronic soft tissue ulcer on her right leg. Immediate management was started including endotracheal intubation, mechanical ventilation, followed by intravenous fluid resuscitation, vasopressors, and empiric Meropenem due to documented beta-lactam anaphylaxis. Laboratory studies were remarkable for elevated white blood cell count (36,700/μL), procalcitonin (17 ng/mL), CRP (13 mg/dL), ESR (110 mm/h), and lactate (7 mmol/L). Acute ischemic infarcts in bilateral frontoparietal regions and a punctate infarct in the right cerebellum were demonstrated on computerized tomography. Transthoracic and transesophageal echocardiography identified a 23 mm mobile vegetation on the aortic valve with severe regurgitation. Serratia marcescens, a gram negative fermenter bacilli susceptible to Meropenem, grew on blood and wound cultures. On hospital day 3, severe neurological deficit was observed due to hemorrhagic transformación of the left middle cerebral artery territory infarct. Discussion: This case underscores the complexity of infective endocarditis in the context of drug use disorders. In this case, a chronic wound represented an unconventional but lethal portal for gram-negative seeding of the aortic valve. Infective endocarditis goes beyond infection and requires a multidisciplinary approach with shared decision making. Though the presence of a large, mobile vegetation, severe valve dysfunction, and systemic embolization were indicative of urgent valve replacement; the hemorrhagic transformation of the MCA territory infarct precluded safe anticoagulation delaying aortic valve replacement. In addition, persistent severe neurological deficit required long-term supportive care such as tracheostomy and percutaneous endoscopic gastrostomy. Early recognition of drug use disorders, multidisciplinary collaboration, and integration of resources are essential to improving outcomes in this high-risk population.

Background/Objectives: The use of percutaneous endoscopic gastrostomy (PEG) offers numerous benefits but is also associated with complications that require specialised management. However, evidence regarding the management of these patients in primary care, both in Spain and internationally, remains limited. The aim of this study was to analyse primary care nurses’ perceptions of their level of knowledge and their needs related to the management of patients with PEG tubes. Methods: A descriptive cross-sectional study was conducted, using an online questionnaire addressed to primary care nurses in Andalusia, Spain. Demographic data, perceived level of knowledge, and perceptions regarding PEG management were collected. Statistical analysis included chi-square and Fisher’s exact tests, as well as a multivariable logistic regression model. Results: A total of 121 nurses participated, where 92.4% had cared for PEG patients and 68.9% had managed complications. Within the total group, older nurses and those with more years of professional experience demonstrated significantly greater knowledge in managing these complications (p < 0.05). However, only 38.5% had received specialised clinical training, and 98.3% expressed the need for continuing professional development. The lack of up-to-date protocols was a recurrent finding, with many nurses relying on referrals to specialist colleagues. Conclusions: Primary care nurses frequently manage PEG-related complications but lack systematic access to evidence-based guidelines and training. This gap underscores the need for structured educational programmes such as practical seminars, simulation-based online modules, regular clinical sessions led by specialist nurses, and clear visual protocols for identifying and managing common complications.

Abstract Introduction Dermatomyositis (DM) is an idiopathic inflammatory myopathy (IIM) that presents with a multitude of manifestations. Anti-NXP-2 antibody positivity is prevalent in approximately 1-17% of adult DM patients and is more common among males and younger patients. Individuals with the NXP-2 autoantibody tend to present with severe muscle weakness, calcinosis, subcutaneous oedema, dysphagia, and minimal interstitial lung disease. We present a case of a 64-year-old gentleman with a delayed response and resistance to treatment. Through this, we highlight the therapeutic challenges in IIMs. Case description A 64-year-old male with a background of schizophrenia presented with a widespread rash on his hands, chest, neck, and face for three months. He complained of pain and weakness in his muscles. There was no dysphagia, nasal regurgitation, diplopia, ptosis, Raynaud’s or cardiorespiratory symptoms. Examination demonstrated an erythematous rash over the extensor surface of the fingers, palms, and proximal muscle weakness with MMT8 of 144/150. Initial blood tests showed normal inflammatory markers and raised CK of 430U/L. Despite his clinical symptoms, his initial myositis ENA blot was negative. There was a notable absence of any characteristic electromyographic findings; however, an MRI shows extensive muscle odema. Prednisolone did cause psychosis, complicating the management. During this period, he further deteriorated with a MMT8 score of 103 and developed dysphagia. Given the onset of dysphagia, a decision was made to commence intravenous immunoglobulins (IVIG), and low-dose prednisolone was continued. Simultaneously, he developed bilateral hand swelling with no synovitis but subcutaneous oedema. A muscle biopsy showed perimysial and perivascular inflammation and perifascicular atrophy, which was in keeping with dermatomyositis. Repeat antibody testing was positive for both NXP2 and TiF1 gamma, and a repeat EMG was suggestive of myositis. He was commenced on methotrexate but couldn’t tolerate it. He was subsequently started on mycophenolate and continued on regular IVIG; however, he continued to have active skin involvement and dysphagia hence, after MDT discussion, was started on rituximab. Despite all these measures, his dysphagia did not improve and a PEG tube was inserted. His skin remained resistant to therapy, resulting in the addition of tacrolimus. Given the resistance to treatment and NXP2 and TIF gamma positivity, an extensive cancer workup was performed, which was negative. He is maintained on monthly IVIG (after discussing with national experts) with tacrolimus. His current MMT8 is 150/150. Discussion This gentleman presented with early signs of dermatomyositis; however, his biochemical and immunology and other investigations did not support this despite clear-cut clinical signs. Antibody testing is subject to temporal change and, in the event of high clinical suspicion, re-testing is advocated. Our patient presents with significant typical skin manifestations, myalgia, proximal muscle weakness, and dysphagia. As NPX2 antibody positivity is directly correlated with malignancy and paraneoplastic manifestations, our patient underwent screening methods, including axial imaging with CT and PET scans, gastroscopy, colonoscopy, and PSA, which remain negative at this current time point, as per IMACS guidelines. With the advent of the latest guidelines from the British Society for Rheumatology, the management and investigative approach for IIMs has become streamlined to ensure homogeneity in patient care throughout the country. Through this case, we aim to highlight that patients may initially be antibody negative with normal EMGs; however, in the correct clinical setting, one should continue to pursue the diagnosis of IIM. Key learning points 1. NXP2 antibody-mediated DM is associated with dysphagia, calcinosis and subcutaneous oedema. 2. NXP2 and TIF gamma antibodies are considered high-risk for a malignancy; if there is a poor response to treatment, it is essential to rule out malignancy. 3. If there is dysphagia, IVIG should be strongly considered in addition to conventional treatment.

MODE OF NUTRITION AS A REFLECTION OF SWALLOWING ABILITY IN ACUTE AND SUB-ACUTE STROKE: VALIDATION OF A BEDSIDE TOOL.

Management of submucosal tumors (SMTs) or subepithelial lesions (SELs) at the cervical esophagus remains technically challenging due to limited maneuvering space and short oral mucosal length for conventional submucosal tunnel endoscopic resection (STER). We propose a novel conceptual approach—endoscopic retrograde submucosal tunnel resection (ER-STER)—which enables retrograde access to cervical esophageal SMTs through a percutaneous endoscopic gastrostomy (PG) and anal submucosal tunnel. This technique could potentially enlarge the working space and reduce manipulation near the upper esophageal sphincter (UES), while introducing uncertainties such as PEG-related morbidity, retrograde tunnel perforation, and mediastinal contamination risk. This hypothesis-generating article outlines the rationale, procedural concept, risk analysis, and a translational roadmap for ER-STER. By shifting tunnel entry to the anal side, ER-STER may address the anatomical limitations of conventional STER and reduce patient discomfort associated with proximal mucosal injury. While still theoretical, this method warrants further exploration for feasibility, safety, and clinical utility.

This review aimed to synthesise current evidence on the effects of gastrostomy in Parkinson's disease (PD) and parkinsonism, Multiple Sclerosis (MS) and Huntington's disease (HD). Evidence regarding the risks and benefits of gastrostomy insertion and use in progressive neurological diseases, excluding Motor Neurone Disease (MND), is lacking, causing gastrostomy decision-making discussions to arise as a matter of debate in practice. Three databases (Web of Science, Ovid Medline and Embase) were searched for research on the impacts of gastrostomy, including survival, complication rates, nutrition changes, in adults with progressive neurological diseases, excluding MND. Quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist: Primary Research, and a narrative synthesis was conducted. Twelve (n = 12) studies were eligible for inclusion, with either retrospective cohort (n = 12) or cross-sectional (n = 1) design, examining the effects of percutaneous endoscopic gastrostomy (PEG) (n = 8), radiologically inserted gastrostomy (RIG) (n = 1) or gastrostomy not further defined (n = 4) in adults with PD (n = 6), parkinsonism (n = 3), MS (n = 3), or HD (n = 3). There was variability in outcomes and comparators with inconclusive results. Quality was assessed as positive (n = 3) or neutral (n = 9). Gastrostomy appears to be associated with increased care needs in the population of interest. Gastrostomy insertion and use in this cohort is poorly investigated. High-quality prospective studies, especially with well-defined nutrition-related outcome measures, and robust statistical analyses are needed to determine the potential benefits of gastrostomy in this population. PROSPERO: CRD42024604136.

Objectives: The use of enteral route in nutritional support therapy is more physiological. It preserves the structural and functional intestinal integrity as well as the intestinal microbial diversity. Percutaneous endoscopic gastrostomy (PEG) is one of the enteral feeding routes. It is indicated for patients who cannot take oral food at all or cannot take oral food for more than 4 to 6 weeks. Methods: Non-cancer patients who had PEG tube placement between November 1, 2024 and May 1, 2025 in the palliative care service were followed prospectively. Patients were divided into two groups: those who were discharged from the palliative care service after PEG tube placement and those who died in the palliative care service after PEG tube placement. It was examined whether the patients had an infection after PEG placement and, if so, what type of infection they had. The study was conducted with the 83 patients. Results: According to the logistic regression analysis results, age and pneumonia after PEG tube placement were found to be risk factors affecting palliative care mortality after PEG tube placement in the palliative care service (respectively; p= 0.017, odds ratio [OR]=1.06, confidence interval [CI] of OR=1.012- 1.126; p=0.004, OR=5.32, CI of OR=1.697- 16.680). Conclusion: Age and pneumonia after PEG tube placement were found to be risk factors affecting palliative care mortality after PEG tube placement in non- cancer palliative care patients.

Background and Objectives: Percutaneous endoscopic gastrostomy (PEG) is a widely accepted method for long-term enteral nutrition, but procedure-related complications and early mortality remain major concerns. Nutritional and inflammatory indices such as serum albumin, C-reactive protein (CRP), Prognostic Nutritional Index (PNI), and Nutrition Risk Screening (NRS-2002) may provide prognostic value, yet comparative data in PEG cohorts are limited. This study aimed to identify predictors of complications and 90-day mortality after PEG and to compare the prognostic performance of nutritional indices. Materials and Methods: A retrospective cohort of 122 consecutive adult patients undergoing PEG between January and December 2024 was analyzed. Demographic, clinical, and laboratory parameters were collected, including albumin, CRP, PNI, and NRS-2002. Complications were categorized as early (≤30 days) or late (>30 days), and all-cause mortality was assessed at 30 and 90 days. Univariate and multivariate logistic regression models were used to evaluate predictors of complications and 90-day mortality. To address multicollinearity, albumin, PNI, and NRS-2002 were separately tested in adjusted models, with model performance assessed by AIC, BIC, Nagelkerke R2, and C-index. Results: Early complications occurred in 4.9% and late complications in 8.2% of patients, for a total complication rate of 13.1%. Thirty-day mortality was 4.1%, 90-day mortality 17.2%, and total in-hospital mortality during the study year 30.3%. Neuromuscular indication was independently associated with increased risk of complications (aOR 5.0, 95% CI 1.2–20.0, p = 0.028) but reduced 90-day mortality (aOR 0.15, 95% CI 0.03–0.80, p = 0.025). Lower baseline albumin independently predicted higher 90-day mortality (aOR 0.92, 95% CI 0.86–0.99, p = 0.034). Elevated CRP demonstrated a borderline association with mortality (p = 0.051), while NRS-2002 ≥5 and Δ-PNI showed borderline trends toward increased mortality risk. In model comparison, none of the nutritional indices achieved independent statistical significance, but all demonstrated similar performance (AIC = 114, C-index 0.72–0.74). Conclusions: PEG outcomes are strongly influenced by baseline indication and nutritional–inflammatory status. Neuromuscular patients and patients with dysphagia face higher complication risk but lower short-term mortality, while hypoalbuminemia, elevated CRP, and high NRS-2002 or declining PNI identify patients at greater risk of death. Systematic integration of albumin, CRP, PNI, and NRS-2002 may improve risk stratification and management in PEG candidates.

Percutaneous endoscopic gastrostomy (PEG) tubes are vital for providing long-term nutritional support to individuals unable to sustain sufficient oral intake. The use of PEG tubes causes significant difficulties for patients and their caregivers. This systematic review and meta-synthesis investigated the challenges and experiences of patients with PEG tubes and their caregivers. A systematic review and meta-synthesis were conducted across databases including CINAHL, Scopus, Web of Science, MEDLINE, PubMed, TUBITAK-ULAKBIM, Dergipark, and TR Dizin. This study focused on studies published from 2004 to 2024. Twenty qualitative and mixed methods studies met the inclusion criteria. Thematic analysis has been used to identify significant themes and patterns within the selected studies. Three main themes and 6 subthemes emerged from the analysis: (1) Clinical challenges and support needs, including problems with the PEG tube and support and training needs; (2) psychological and emotional challenges, including perception of the PEG as a burden and stigma and social isolation; and (3) personal and social life, including impact on quality of life and economic challenges. These results revealed the complex nature of PEG care and illustrate the experiences and challenges of patients and carers. The management of gastrostomy care requires a comprehensive strategy that addresses the clinical, economic, emotional, and psychosocial needs of patients and caregivers. Planning such as comprehensive education, emotional support, and financial assistance can improve the quality of life of patients and carers. Future research should focus on developing customized strategies to handle the specific caregiving challenges in this context.

Abstract An 8‐month‐old, female, entire Maine Coon cat initially presented with spastic monoparesis of the right hindlimb that progressed to generalised spastic paresis over the ensuing days. A clinical diagnosis of generalised tetanus prompted the initiation of intensive supportive care, including antibiotics, skeletal muscle relaxants, analgesics and diligent nursing care. The cat developed a hiatal hernia, megaoesophagus and aspiration pneumonia. To meet the cat's nutritional requirements and to mitigate potential complications associated with dysfunctional swallowing, a percutaneous endoscopic gastrostomy tube was placed. After 21 days of hospitalisation, the patient was discharged. It took approximately 17 months for complete recovery, according to the owners. This case demonstrates the use of a percutaneous endoscopic gastrostomy tube to meet the nutritional needs and bypass the dysfunctional oesophagus of a cat with the uncommon diagnosis of generalised tetanus.

One-step button percutaneous endoscopic gastrostomy (B-PEG) is a method for gastrostomy placement. Few studies have described complications associated with T-fasteners. This study aimed to assess the incidence and risk factors of post-gastrostomy T-bar retention. Children who underwent one-step button percutaneous endoscopic gastrostomy (B-PEG) placement in our tertiary center between 2009 and 2020 were included in this retrospective study. Patient characteristics, comorbidities, complications, and potential risk factors were analyzed. All post-procedure radiological examinations, T-bar numbers, and durations post-procedure were collected. T-bar retention was considered at least one T-bar after 6 weeks post-B-PEG. A total of 679 children (337 boys; median age at B-PEG, 1.7 years) were included. Among 483 patients with radiological examinations analyzed, 361 (74.7%) had at least one T-bar impaction at the first radiological examination (median time after B-PEG, 0.55 years). Younger age at B-PEG was a risk factor for T-bar impaction (odds ratio [OR]: 2.82, 95% confidence interval [CI]: [1.71–4.66], P < .0001). Nearly 75% of children presented T-bar impaction. These data indicate that to avoid gastropexy complications, discussion of early removal of T-fasteners post-B-PEG is warranted.

343 Background: Despite intensity modulated radiation therapy for patients with head and neck cancer, oral mucositis pain remains common leading to hospitalization. However, there is a heterogeneous practice pattern in prophylactic percutaneous endoscopic gastrostomy (PEG) tube use, and it is unclear whether increased hospitalization is driven by those with versus without prophylactic PEG tube. To address this knowledge gap, we performed an observational cohort study to evaluate the association of PEG tube with hospitalization and other clinical outcomes. Methods: Our single institution database was queried for patients with non-metastatic head and neck cancer diagnosed between October 2011 and December 2023 who received definitive radiation or chemoradiation. Reasons for hospitalization during and within 3 months after treatments were summarized. Fine-Gray multivariable analysis (MVA) was performed to identify variables associated with time to first hospitalization. Logistic MVA was used to identify variables associated with first hospitalization and readmission. Cox MVA and Fine-Gray MVA were performed to analyze survival and tumor recurrence outcomes. Bonferroni correction was used for multiple comparisons with P &lt; 0.025 for statistical significance. Results: A total of 560 patients were identified (n = 141 [25.2%] with prophylactic PEG tube, n = 203 [36.3%] with no PEG tube, n = 216 [38.6%] with therapeutic PEG tube). Median follow up was 44.9 months (95% confidence interval [CI] 43.0-46.6). Overall, 249 (44.5%) and 94 (16.8%) were hospitalized once and multiple times, respectively. Three most common reasons for hospitalization were: failure to thrive (n = 192 [33.9%]), fever or infection (n = 83 [14.7%]), and low blood count (n = 50 [8.8%]). On Fine-Gray MVA for time to first hospitalization, no PEG tube was associated with less hospitalization (adjusted hazards ratio [aHR] 0.64, 95% CI 0.45-0.91, p = 0.01), but not therapeutic PEG tube (aHR 1.16, 95% CI 0.84-1.59, p = 0.38) when compared to prophylactic PEG tube. Similar findings were noted on logistic MVA (no PEG tube: adjusted odds ratio [aOR] 0.58, 95% CI 0.36-0.92, p = 0.023; therapeutic PEG tube: aOR 1.24, 95% CI 0.79-1.95, p = 0.36). When no PEG tube and therapeutic PEG tube were each compared to prophylactic PEG tube, there was no statistical significance for readmission, overall survival, progression-free survival, locoregional failure, and distant failure. Similar findings were noted when stratified by p16 status. Conclusions: Our study suggested that nearly half of patients were hospitalized at least once during and within 3 months after treatments, and the most common reason was failure to thrive. Those who never had PEG tube had the lowest hospitalization rate, while prophylactic PEG tube was not associated with less hospitalization compared to those with therapeutic PEG tube.

Traumatic brain injury (TBI) is a global health problem. Amantadine and citicoline showed considerable effects on neurorecovery from TBI. In a randomized controlled trial, the effects of amantadine and citicoline and their combinations were compared on arousal and behavioral consequences in the early phase of moderate TBI. Patients were divided into three groups (15 patients each) with moderate TBI; group C (citicoline) received 1 g citicoline every 12 h for 7 days. Participants received 500 mg oral drops syrup twice a day or the same dose as oral drops syrup of citicoline through a nasogastric tube (NG) or percutaneous endoscopic gastrostomy (PEG) tube in a total dose of 1000 mg/day for a 30-day study period. Group A (amantadine) received 200 mg of amantadine sulfate in a 500 mL solution every 12 h for 7 days. Participants received two 100-mg tablets twice a day or through an NG or PEG tube as 400 mg for a 30-day study period. Group CA (Citicoline + Amantadine) received 1 g citicoline every 12 h and 200 mg of amantadine sulfate in a 500 mL solution every 12 h for 7 days, then 500 mg of citicoline syrup twice daily plus 200 tablets twice daily amantadine for a 30-day study period. Glasgow Coma Scale (GCS), Disability Rating Scale (DRS), and mini-mental state (MMS) were used to assess the patient's conditions on the 1st, 4th, and 7th days (acute phase) in the intensive care unit (ICU), then 30 days after injury. The endpoints of the study were either the death of the patient or the completion of the study period of 30 days. The number of mechanically ventilated patients, the number of ventilated days, mortality, total ICU, and hospital length of stay were measured. GCS on days 4, 7, and 30 were significantly higher in group A and group CA compared with group C, with no significant differences between groups A and CA. DRS in days 4 and 7 became significantly lower in groups A and CA compared with group C, with no significant differences between groups A and CA. MMS in days 4, 7, and 30 became significantly lower in group C, with no significant differences between groups A and CA. The duration of mechanical ventilation, ICU, and hospital stay was significantly longer in group C, with no significant differences between groups A and CA. This study showed that amantadine alone or in combination with citicoline has a favorable effect on the recovery of consciousness and cognitive behavior in patients with moderate TBI and reduces the mechanical ventilation days, hospital, and ICU length of stay.

We outline a quality improvement project on the development of a percutaneous endoscopic gastrostomy (PEG) pathway for patients with motor neuron disease (MND) in a single UK specialist hospital. Data were collected for 110 patients with MND from 2011 to 2014 before the development of the MND PEG pathway in 2015 and thereafter from 2018 to 2022. Time from MND diagnosis to PEG discussion, time from discussion to referral, and time from referral to PEG insertion were shorter under the new pathway which is of clinical significance, although not statistically significant. The infection rate post-PEG insertion was significantly reduced. Financial savings were made due to the reduced length of stay and no intensive care unit admissions post-PEG insertion. Our PEG pathway standardized and streamlined services resulting in reduction of total time taken in the pathway: from initial discussion to decision and procedure. It also reduced post-PEG infections and overall costs.

In interventional radiology (IR) for malignant bowel obstruction, treatment is broadly classified into drainage and stent placement. In cases such as terminal-stage malignancy, where removal of a nasogastric or ileus tube is unlikely, gastrostomy or stent placement may be performed endoscopically. However, for patients in whom endoscopic gastrostomy is difficult-such as those with anatomical or procedural limitations-IR-guided access for gastrointestinal decompression can be considered. Representative procedures include percutaneous radiologic gastrostomy (PRG), also referred to as radiologically inserted gastrostomy (RIG), and percutaneous transesophageal gastro-tubing (PTEG). In specific cases such as afferent loop syndrome, stent placement through a percutaneous transhepatic biliary drainage (PTBD) route may also be utilized. These IR procedures are generally performed under local anesthesia and are relatively minimally invasive, making them a viable option in palliative care.

S729 Evaluating Surgical, Radiologic and Endoscopic PEG Tube Outcomes: A National Inpatient Sample Analysis

Background: Malignant tracheoesophageal fistula (mTEF) is a serious complication of advanced esophageal cancer, often the result of tumor eroding into the airway. Without prompt intervention, aspiration and respiratory compromise can rapidly become life threatening. Case: We describe a 76 year old male with middle esophageal squamous cell carcinoma, previously treated with chemo-radiotherapy and immunotherapy, followed by semi covered self-expanding metallic stent (SEMS) placement in esophagus for palliation of dysphagia. Due to tumor spread above esophageal SEMS causing dysphagia, stent over stent was placed. Later he developed mTEF, 3 cm above carina of about 1 cm diameter with upper margin of esophageal SEMS just below the fistulous opening. A 6 cm long fully covered tracheal SEMS was deployed via rigid bronchoscopy to seal the defect, accompanied by percutaneous endoscopic gastrostomy (PEG) placement to secure enteral nutrition. His symptoms resolved immediately, and follow-up at two months showed the stent remained well positioned. Conclusion: For patients with advanced esophageal cancer and mTEF due to tumor invasion, rigid bronchoscopy guided fully covered tracheal stenting offers rapid airway protection and effective palliation, especially when esophageal stenting is not feasible or it fails.

ABSTRACTObjectivesPatients requiring long‐term enteral nutrition or continuous infusion of carbidopa/levodopa can benefit from jejunostomy tube placement. Recently, directly placed percutaneous transgastric jejunal tubes (TGJs) have been used instead of gastrostomy tubes with jejunal extensions (PEG‐Js) for enteral access. We aim to compare patient characteristics and outcomes after placement of TGJs placed via the introducer technique compared to PEG‐Js.MethodsWe performed a retrospective study of 141 patients (TGJ = 58, PEG‐J = 83) assessed at Mayo Clinic between 2010 and 2024. Patients were identified using a prospectively maintained procedure data registry. Demographic data, patient characteristics, procedural indications, complications, and first‐replacement date were gathered. Statistical analysis included the Wilcoxon rank sum test, chi‐square test, Fisher's exact test, and Kaplan‐Meier estimates. Patients receiving carbidopa/levodopa were excluded from complications analysis due to the carbidopa/levodopa tube's proprietary structure. A p‐value of <0.05 was set as a threshold for significance.ResultsOur results demonstrated no difference in cumulative incidence of complications within 1 year for TGJs and PEG‐Js, p‐value 0.48. Regarding time to first replacement, treating death as a competing risk factor, there was no statistically significant difference in cumulative incidence of replacement within 1 year for TGJs and PEG‐Js, p‐value 0.389.ConclusionsOur study demonstrates that both direct TGJs and PEG‐Js are safe options for long‐term jejunal feeding. More studies are needed to compare endoscopic to radiologically placed percutaneous transgastric jejunal feeding tubes.

Objectives: This study aimed to determine the prevalence of gastrostomy-related procedures and paediatric patients undergoing these procedures, alongside temporal trends, patient profiles, and regional disparities in procedure provision. Methods: We analysed anonymised National Health Fund data pertaining to patients who underwent procedures at regional centres in Poland from 2010 to 2019. To assess temporal patterns, procedure counts and patient prevalence were aggregated annually, and trends over time were evaluated using the Mann–Kendall trend test. Results: Percutaneous Endoscopic Gastrostomy (PEG) was performed in 2638 patients, while gastrostomy-other was performed in 2087 patients. The cumulative prevalence of patients during the 10-year follow-up period was as follows: PEG: 37.7 per 100,000 children; gastrostomy—other: 29.9 per 100,000 children. The procedure prevalence rates were PEG: 40.1 per 100,000 children; gastrostomy-other: 43.0 per 100,000 children. Gastrostomy-related procedures were performed most frequently in the first three years of life. Conclusions: Patient sex, age, and centre location influenced utilization, as shown by local variations. The increasing trend in gastrostomy procedures and the young patient age indicate the growing use of gastrostomy, with endoscopic placement being the most common. Given the rising numbers requiring gastrostomy, optimizing inter-centre collaboration could contribute to the identification and treatment of patients with special nutritional needs.

Endosonography guided Coloenterostomy for Palliative Management of Peritoneal Carcinomatosis.