Percutaneous Transesophageal Gastrotubing Research Articles

Patient characteristics and procedural and safety outcomes of percutaneous transesophageal gastro-tubing: A nationwide database study in Japan

BackgroundPercutaneous transesophageal gastro-tubing (PTEG) is an alternative interventional procedure in cases where gastrostomy is not feasible. However, the safety and complication rates of PTEG have not yet been evaluated. We aimed to describe the characteristics of patients who underwent PTEG and investigate complications using a nationwide Japanese inpatient database. MethodsIn this retrospective cohort study, we used the Diagnosis Procedure Combination database in Japan to identify patients who underwent PTEG from April 2012 to March 2020. The outcomes were the occurrence of complications, invasive treatment within 7 days after PTEG, and tube replacement within 14 days after PTEG. We statistically compared patient background, complication rates, and outcomes using PTEG indications. ResultsA total of 3,684 patients underwent PTEG, which was performed in 1,455 patients for decompression and 2,193 patients for feeding. The patients’ mean age was 73.1 years, and 62.1% were men. More patients in the decompression group had cancer than those in the feeding group. The overall number of complications was 47 cases (1.3%). The most common treatment administered after PTEG was red blood cell transfusion (3.9%), followed by early tube replacement (3.3%). As invasive treatments for PTEG complications, percutaneous drainage and transcatheter arterial embolization were required in 4 and 1 cases, respectively, and no cases required surgery. ConclusionWe performed a descriptive study on PTEG using a nationwide database in Japan. This study also showed a low complication rate after PTEG in the real world. Our findings provide practical information on the safety of PTEG in Japan.

Techniques for Percutaneous Transesophageal Gastro-tubing in the Management of Gastric Leak or Dysphasia After Sleeve Gastrectomy

Techniques for Percutaneous Transesophageal Gastro-tubing in the Management of Gastric Leak or Dysphasia After Sleeve Gastrectomy

Retrospective assessment of 73 cases treated with percutaneous transesophageal gastrotubing (PTEG) and comparison of complication rate with percutaneous endoscopic gastrostomy (PEG)

Retrospective assessment of 73 cases treated with percutaneous transesophageal gastrotubing (PTEG) and comparison of complication rate with percutaneous endoscopic gastrostomy (PEG)

Double PTEG (percutaneous trans-esophageal gastro-tubing) was useful in nutrition and decompression for a gastric cancer patient with pyloric stenosis: a case report

Background For gastric cancer patients with strong pyloric stenosis, decompression by nasogastric tube insertion for gastric distension and central venous nutrition management have been performed. However long-term indwelling of the nasogastric tube is accompanied by pain, and Central venous catheter placement is inferior to enteral nutrition from infection risk and nutritional viewpoint. Furthermore, these generally require management in hospitalization. Case presentation An 81-year-old male was referred to our hospital for gastric cancer accompanied by pyloric stenosis. Blood test resulted in low nutrition and anemia. CT showed thickening of the wall from the anterior gastric part to the pylorus and enlargement of 50mm in the regional lymph node, and gastric distention. We planned resection after preoperative chemotherapy. We performed double PTEG (Percutaneous Tran Esophageal Gastro-tubing) from cervical co-wound for decompression and nutrition management of the stomach. Total laparoscopic gastrectomy was performed on day 114 after insertion of the double PTEG. During which time he had been good nutrition and no gastric distention with stayed at home for 42 days. On the 10th postoperative day, he was clinically released from hospital without any complications. Conclusions We conducted a new management to reduce and nourish patients with gastric cancer who had a pyloric stenosis by double PTEG (percutaneous trans-esophageal gastro-tubing), and can perform curative surgery after preoperative chemotherapy including home management period.

A case of percutaneous endoscopic duodenostomy (PED) after gastrectomy: Comparison of PED and percutaneous transesophageal gastro-tubing (PTEG)

A case of percutaneous endoscopic duodenostomy (PED) after gastrectomy: Comparison of PED and percutaneous transesophageal gastro-tubing (PTEG)

Our trial to enlighten the technique of percutaneous transesophageal gastrotubing (PTEG) from Japan to the World

Rationale: In all of the world, the way of giving the nourishment to the patients with swallow disturbance is only Nasogastric tubing. In Japan, PTEG has been common as the salvage method of the case that is impossible to be performed with Percutaneous Endoscopic Gastrostomy(PEG) due to several reasons, for example, the deficit of stomach after gastrectomy. However, there are some cases that need PTEG in spite of no experience of gastrectomy due to no safty zone of PEG procedure, for instance, stomach covered by transverse colon. We can use the commercial based kit (Sumitomo Bakelite Co.ltd. Tokyo, Japan) which set includes 70cm Rupture Free Balloon(RFB) Catheter.

Percutaneous transesophageal gastro-tubing for the management of anastomotic leakage after upper GI surgery: a report of two clinical cases

BackgroundAnastomotic leakage is a serious, sometimes critical complication of upper gastrointestinal (GI) surgery. The cavity and target drainage tubes are difficult to reach; therefore, a nasogastric tube (NGT) and fasting are required for an extended period. We successfully treated and managed two patients with anastomotic leakage using percutaneous transesophageal gastro-tubing (PTEG).Case presentationIn case 1, a 79-year-old man with gastric cancer underwent total gastrectomy; 1 week later, he underwent emergent open laparotomy due to panperitonitis attributed to anastomotic leakage-related jejunojejunostomy. We resected the portion between esophagojejunostomy and jejunojejunostomy and reconstructed it using the Roux-en-Y technique. On postoperative day (POD) 9, anastomotic leakage was diagnosed at the esophagojejunostomy site and jejunotomy staple line. After using a circular stapler for jejunojejunostomy, a stapled jejunal closure was added. We inserted an NGT and performed aspiration for bowel decompression. As he did not improve within 2 weeks, we decided to perform PTEG to free him of the NGT. We kept performing intermittent aspiration; leakage stopped shortly after, due to effective inner drainage. The PTEG catheter was removed after oral intake was restarted. In case 2, an 81-year-old man with esophagogastric junction cancer underwent resection of the distal esophagus and proximal stomach. After shaping the remnant stomach, esophagogastrostomy was performed under the right thoracotomy. On POD 11, anastomotic leakage was identified, along with a mediastinal abscess. We inserted an NGT into the abscess cavity through the anastomotic leakage site. On POD 25, we performed PTEG and inserted a drainage tube, instead of an NGT. Although the abscess cavity disappeared, anastomotic leakage persisted as a fistula. We exchanged the PTEG with a double elementary diet (W-ED) tube with jejunal extension, with the side hole located near the anastomosis. The anastomotic fistula disappeared after treatment. Dysphagia persisted due to disuse atrophy of swallowing musculature; PTEG was useful for enteral feeding, even after the leakage occurred.ConclusionPatients are sometimes forced to endure pain for a long time for transnasal inner drainage. Using PTEG, patients will be free of sinus pain and discomfort; PTEG should be helpful for patients withstanding NGT.

Percutaneous Transesophageal Gastro-Tubing as an Alternative Procedure of Levodopa Administration in Parkinson's Disease.

Percutaneous Transesophageal Gastro-Tubing as an Alternative Procedure of Levodopa Administration in Parkinson's Disease.

3:45 PM Abstract No. 223 Percutaneous transesophageal gastro-tubing as an alternative to percutaneous gastrostomy: a multi-hospital academic institution’s case series of 14 patients

3:45 PM Abstract No. 223 Percutaneous transesophageal gastro-tubing as an alternative to percutaneous gastrostomy: a multi-hospital academic institution’s case series of 14 patients

Percutaneous Gastrojejunostomy Catheter Placement Using a Slow-Leak Balloon through the Reconstructed Gastric Tube after Esophagectomy.

Twelve patients who had undergone esophageal reconstruction because of cancer and in whom conventional percutaneous radiologic or endoscopic gastrostomy was considered difficult are reported. These patients underwent placement of a percutaneous gastrojejunostomy catheter through the reconstructed gastric tube using a slow-leak balloon that had been developed for percutaneous transesophageal gastrotubing. Retrospective evaluation showed successful outcomes without severe complications in all patients. Eight (66.6%) were able to resume oral intake, which allowed gastrojejunostomy catheter withdrawal in 3 (25%). This technique is feasible with acceptable clinical outcomes for patients who have undergone gastric tube reconstruction after esophagectomy.

Two cases of percutaneous transesophageal gastro-tubing insertion for the improvement of QOL against malignant bowel obstruction

Two cases of percutaneous transesophageal gastro-tubing insertion for the improvement of QOL against malignant bowel obstruction

Case report: a patient who underwent endoscopic percutaneous transesophageal gastro-tubing that was improved to avoid complications

Case report: a patient who underwent endoscopic percutaneous transesophageal gastro-tubing that was improved to avoid complications

A randomized, controlled trial of the efficacy of percutaneous transesophageal gastro-tubing (PTEG) as palliative care for patients with malignant bowel obstruction: the JIVROSG0805 trial.

A randomized, controlled trial to evaluate the superiority of percutaneous transesophageal gastro-tubing over nasogastric tubing as palliative care for bowel obstruction in patients with terminal malignancy was conducted. The subjects were patients with malignant bowel obstruction with no prospect of improvement, for whom surgery was not indicated and with a Palliative Prognostic Index of < 6. They were randomly allocated in a 1:1 ratio to receive either percutaneous transesophageal gastro-tubing (PTEG group) or nasogastric tubing (NGT group). Their symptom scores (the worst 0 to no symptoms 10) were measured for a 2-week period after enrollment, and the areas under the curves for the two groups were compared. The EQ-5D and SF-8 were also used to assess overall quality of life. Forty patients were enrolled between October 2009 and January 2015, with 21 allocated to the PTEG group and 19 to the NGT group. The mean areas under the curves (95% confidence intervals) for the PTEG group and the NGT groups were 149.6 (120.3-178.8) and 44.9 (16.4-73.5), respectively, significantly higher for the NGT group (p < 0.0001). The secondary endpoints of quality of life as assessed by the EQ-5D and SF-8 scores were also significantly higher for patients in the PTEG group (p = 0.0036, p = 0.0020). There was no difference in survival between the groups. No serious adverse events were observed. In terms of quality of life, percutaneous transesophageal gastro-tubing was superior to nasogastric tubing as palliative care for patients with bowel obstruction due to terminal malignancy.

Double Percutaneous Trans-Esophageal Gastro-tubing により保存的治療が可能であった超高齢者十二指腸潰瘍穿孔の1例

Double Percutaneous Trans-Esophageal Gastro-tubing により保存的治療が可能であった超高齢者十二指腸潰瘍穿孔の1例

当院での人工的水分・栄養補給法の変遷 －経皮経食道胃管挿入術導入と栄養サポートチームの活動－

当院での人工的水分・栄養補給法の変遷 －経皮経食道胃管挿入術導入と栄養サポートチームの活動－

SUN-PO265: Usefulness of Nutrition Management by Percutaneous Trans-Esophageal Gastro-Tubing

SUN-PO265: Usefulness of Nutrition Management by Percutaneous Trans-Esophageal Gastro-Tubing

Hydro-dissection assisted puncture of an esophageal balloon for percutaneous transesophageal gastrotubing: early experience concerning the technical feasibility, safety, and efficacy.

BackgroundPercutaneous transesophageal gastrotubing (PTEG) is an alternative means of access into the stomach when conventional transabdominal gastric access is not possible.PurposeTo describe the ...

Double Percutaneous Transesophageal Gastrotubing for Gastric Cancer: A Pilot Study

BackgroundThe management of gastric cancer causing gastric outlet obstruction and dilatation must include decompression of the stomach and intravenous nutrition. Percutaneous transesophageal gastrotubing (PTEG) is an effective technique for either gastric decompression or enteral nutrition. Here, we investigated the efficacy and safety of double PTEG (dPTEG), that is, using PTEG for both purposes simultaneously, in patients with gastric cancer. Materials and methodsEleven patients with gastric outlet obstruction due to gastric cancer were admitted to our hospital between January 2015 and March 2017 and enrolled in this study. Each patient underwent dPTEG as soon as possible. After dPTEG tubes were placed, gastric decompression was started immediately and enteral nutrition was started within 1 d. Feeding and decompression through the double tubes were continued until the day before operation. Using data from these patients, we investigated the efficacy and safety of dPTEG. ResultsdPTEG was performed successfully in all patients and no critical adverse effects were observed. Eight of the 11 patients underwent radical or palliative resection. Decompression of the stomach was achieved and nutritional status was significantly improved after dPTEG in all patients. ConclusionsWe conclude that dPTEG is a safe and effective management technique for patients with gastric outlet obstruction and gastric dilatation due to gastric cancer.

Randomized controlled trial of percutaneous transesophageal gastrotubing for symptom palliation in patients with malignant gastrointestinal obstruction.

10090Background: Malignant gastrointestinal obstruction occurs in approximately 10-16% of end-stage cancer patients. Nasogastric tubing (NGT) is a standard palliative treatment; however, NGT causes...

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

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.