Universität zu Köln

Schaefer, Hartmut, Vivaldi, Carlo, Herbold, Till, Brinkmann, Sebastian, Maus, Martin, Bludau, Marc, Toex, Ulrich, Goeser, Tobias, Hoelscher, Arnulf H. and Leers, Jessica M. (2017). Percutaneous Endoscopic Gastrostomy in Direct Puncture Technique: When, Why and How? Dig. Surg., 34 (1). S. 52 - 60. BASEL: KARGER. ISSN 1421-9883

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Abstract

Background: Percutaneous endoscopic gastrostomy (PEG) placed in the pull through (PT) technique is a common procedure to restore enteral feeding in patients with swallowing disorders. Limitations of this technique are patients with obstruction of the pharynx or esophagus or with an esophageal stent. We report our experience with the direct puncture (DP) PEG device. Methods: We included 154 patients (55 women). One hundred forty patients had cancer. After passing the endoscope into the stomach, 4 gastropexies were performed with a gastropexy device and the PEG was placed with the introducer method. After 1 month, the sutures were removed and a constant gastrocutaneous fistula had been created and the new catheter could be placed safely. Results: The DP PEG was successfully placed in all patients. Overall complication rate was 11% (minor: 6%, major: 5%). The most common event was tube dislocation (40 cases). In 5 cases of dislocation, this resulted in a major complication with injuring the gastric wall and the necessity for surgical treatment. Conclusions: The DP PEG system is safe, and can be used in cases in which a standard PT PEG is not feasible. To avoid dislocation, strict adherence to a post-interventional protocol is highly recommended. (C) 2016 S. Karger AG, Basel

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schaefer, Hartmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Vivaldi, Carlo UNSPECIFIED UNSPECIFIED UNSPECIFIED Herbold, Till UNSPECIFIED UNSPECIFIED UNSPECIFIED Brinkmann, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Maus, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Bludau, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Toex, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Goeser, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leers, Jessica M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-248626
DOI:	10.1159/000447726
Journal or Publication Title:	Dig. Surg.
Volume:	34
Number:	1
Page Range:	S. 52 - 60
Date:	2017
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1421-9883
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SQUAMOUS-CELL CARCINOMA; CANCER-PATIENTS; INTRODUCER METHOD; PERISTOMAL INFECTION; ESOPHAGEAL CANCER; TUBE PLACEMENT; NECK-CANCER; PULL METHOD; COMPLICATIONS; HEAD Multiple languages Gastroenterology & Hepatology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24862