Gastrostomy Tube Placement by Radiological Methods for Older Patients Requiring Enteral Nutrition: Not to be Forgotten
Background: The use of gastrostomy tubes for long-term nutritional support in older patients is frequent. Percutaneous gastrostomy tube placement may be performed using various techniques, including endoscopic, surgical, and radiologically-guided methods. While percutaneous endoscopic gastrostomy (P...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-09-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fmed.2018.00274/full |
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| author | Vered Hermush Vered Hermush Yitshal Berner Yael Katz Yael Katz Yanina Kunin Yanina Kunin Irena Krasniansky Irena Krasniansky Yael Schwartz Yael Schwartz Debbie Mimran Nahon Debbie Mimran Nahon Ana Elizariev Ana Elizariev Gad Mendelson Gad Mendelson |
| author_facet | Vered Hermush Vered Hermush Yitshal Berner Yael Katz Yael Katz Yanina Kunin Yanina Kunin Irena Krasniansky Irena Krasniansky Yael Schwartz Yael Schwartz Debbie Mimran Nahon Debbie Mimran Nahon Ana Elizariev Ana Elizariev Gad Mendelson Gad Mendelson |
| author_sort | Vered Hermush |
| collection | DOAJ |
| description | Background: The use of gastrostomy tubes for long-term nutritional support in older patients is frequent. Percutaneous gastrostomy tube placement may be performed using various techniques, including endoscopic, surgical, and radiologically-guided methods. While percutaneous endoscopic gastrostomy (PEG) placement is the most widely used and accepted approach, experience with the use of percutaneous radiological gastrostomy (PRG) is more limited.Objective: To evaluate the safety and short-term outcomes of PRG in older patients requiring long-term enteral feeding.Method: We performed a prospective study involving all patients aged 65 years and older who underwent PRG insertion at the Laniado hospital over a period of 2 years. Adverse events related to the gastrostomy tube insertion were recorded over a period of 3 months following the procedure.Results: A total of 58 patients were included with a mean age of 78.1 years, and 48% were women. The most frequent indications for enteral feeding were stroke (47%) and dementia (41%). The technical success rate was 100% with no immediate procedure-related mortality or morbidity. One-month mortality was 3%, and overall mortality at 3-month follow-up was 16%. Complications were reported in 39 (67%) of patients, with 17 (29%) experiencing more than 1 complication. While most complications (88%) were minor, major complications occurred in 19 (33%) of the patients. Peritonitis was the cause of death in 2 patients, and tube dislodgment occurred in 17 subjects. During the follow-up period 17 (29%) of patients were re-admitted to hospital, with the cause for re-hospitalization being unrelated to the PRG in half of the cases. Neither bleeding nor deep wound infection was detected in the study group.Conclusions: PRG is relatively safe and effective for gastrostomy placement in older patients, and this technique may be of value in patients with oral infections and those receiving anti-thrombotic therapy. |
| first_indexed | 2024-12-19T17:03:49Z |
| format | Article |
| id | doaj.art-0d25d8ce2efd47f69587c0723044faf2 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-19T17:03:49Z |
| publishDate | 2018-09-01 |
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| series | Frontiers in Medicine |
| spelling | doaj.art-0d25d8ce2efd47f69587c0723044faf22022-12-21T20:13:14ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2018-09-01510.3389/fmed.2018.00274355088Gastrostomy Tube Placement by Radiological Methods for Older Patients Requiring Enteral Nutrition: Not to be ForgottenVered Hermush0Vered Hermush1Yitshal Berner2Yael Katz3Yael Katz4Yanina Kunin5Yanina Kunin6Irena Krasniansky7Irena Krasniansky8Yael Schwartz9Yael Schwartz10Debbie Mimran Nahon11Debbie Mimran Nahon12Ana Elizariev13Ana Elizariev14Gad Mendelson15Gad Mendelson16Department of Geriatrics and Skilled Nursing, Laniado Medical Center, Netanya, IsraelRuth and Bruce Rappaport Faculty of Medicine, Technion—Isreal Istitute of Technology, Haifa, IsraelDepartment of Geriatric Medicine, Meir Medical Center, Kfar Saba and Sackler Medical School, Tel Aviv University, Kfar Saba, IsraelRuth and Bruce Rappaport Faculty of Medicine, Technion—Isreal Istitute of Technology, Haifa, IsraelDorot Geriatric and Rehabilitation Center, Netanya, IsraelRuth and Bruce Rappaport Faculty of Medicine, Technion—Isreal Istitute of Technology, Haifa, IsraelDorot Geriatric and Rehabilitation Center, Netanya, IsraelRuth and Bruce Rappaport Faculty of Medicine, Technion—Isreal Istitute of Technology, Haifa, IsraelDorot Geriatric and Rehabilitation Center, Netanya, IsraelDepartment of Geriatrics and Skilled Nursing, Laniado Medical Center, Netanya, IsraelRuth and Bruce Rappaport Faculty of Medicine, Technion—Isreal Istitute of Technology, Haifa, IsraelRuth and Bruce Rappaport Faculty of Medicine, Technion—Isreal Istitute of Technology, Haifa, IsraelDorot Geriatric and Rehabilitation Center, Netanya, IsraelDepartment of Geriatrics and Skilled Nursing, Laniado Medical Center, Netanya, IsraelRuth and Bruce Rappaport Faculty of Medicine, Technion—Isreal Istitute of Technology, Haifa, IsraelRuth and Bruce Rappaport Faculty of Medicine, Technion—Isreal Istitute of Technology, Haifa, IsraelDorot Geriatric and Rehabilitation Center, Netanya, IsraelBackground: The use of gastrostomy tubes for long-term nutritional support in older patients is frequent. Percutaneous gastrostomy tube placement may be performed using various techniques, including endoscopic, surgical, and radiologically-guided methods. While percutaneous endoscopic gastrostomy (PEG) placement is the most widely used and accepted approach, experience with the use of percutaneous radiological gastrostomy (PRG) is more limited.Objective: To evaluate the safety and short-term outcomes of PRG in older patients requiring long-term enteral feeding.Method: We performed a prospective study involving all patients aged 65 years and older who underwent PRG insertion at the Laniado hospital over a period of 2 years. Adverse events related to the gastrostomy tube insertion were recorded over a period of 3 months following the procedure.Results: A total of 58 patients were included with a mean age of 78.1 years, and 48% were women. The most frequent indications for enteral feeding were stroke (47%) and dementia (41%). The technical success rate was 100% with no immediate procedure-related mortality or morbidity. One-month mortality was 3%, and overall mortality at 3-month follow-up was 16%. Complications were reported in 39 (67%) of patients, with 17 (29%) experiencing more than 1 complication. While most complications (88%) were minor, major complications occurred in 19 (33%) of the patients. Peritonitis was the cause of death in 2 patients, and tube dislodgment occurred in 17 subjects. During the follow-up period 17 (29%) of patients were re-admitted to hospital, with the cause for re-hospitalization being unrelated to the PRG in half of the cases. Neither bleeding nor deep wound infection was detected in the study group.Conclusions: PRG is relatively safe and effective for gastrostomy placement in older patients, and this technique may be of value in patients with oral infections and those receiving anti-thrombotic therapy.https://www.frontiersin.org/article/10.3389/fmed.2018.00274/fullelderlyenteral nutritionpercutaneous radiological gastrostomysurvivalfeeding tube |
| spellingShingle | Vered Hermush Vered Hermush Yitshal Berner Yael Katz Yael Katz Yanina Kunin Yanina Kunin Irena Krasniansky Irena Krasniansky Yael Schwartz Yael Schwartz Debbie Mimran Nahon Debbie Mimran Nahon Ana Elizariev Ana Elizariev Gad Mendelson Gad Mendelson Gastrostomy Tube Placement by Radiological Methods for Older Patients Requiring Enteral Nutrition: Not to be Forgotten Frontiers in Medicine elderly enteral nutrition percutaneous radiological gastrostomy survival feeding tube |
| title | Gastrostomy Tube Placement by Radiological Methods for Older Patients Requiring Enteral Nutrition: Not to be Forgotten |
| title_full | Gastrostomy Tube Placement by Radiological Methods for Older Patients Requiring Enteral Nutrition: Not to be Forgotten |
| title_fullStr | Gastrostomy Tube Placement by Radiological Methods for Older Patients Requiring Enteral Nutrition: Not to be Forgotten |
| title_full_unstemmed | Gastrostomy Tube Placement by Radiological Methods for Older Patients Requiring Enteral Nutrition: Not to be Forgotten |
| title_short | Gastrostomy Tube Placement by Radiological Methods for Older Patients Requiring Enteral Nutrition: Not to be Forgotten |
| title_sort | gastrostomy tube placement by radiological methods for older patients requiring enteral nutrition not to be forgotten |
| topic | elderly enteral nutrition percutaneous radiological gastrostomy survival feeding tube |
| url | https://www.frontiersin.org/article/10.3389/fmed.2018.00274/full |
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