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Feasibility of the cut-and-push method for removing large-caliber soft percutaneous endoscopic gastrostomy devices
- Source :
- Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. 28(4)
- Publication Year :
- 2013
-
Abstract
- Introduction Percutaneous endoscopic gastrostomy (PEG) is the method of choice for long-term nutrition in patients with longstanding eating difficulties due to pathological entities that impair swallowing. The feeding catheters are designed to be removed by external traction or by endoscopy. Aim To evaluate the feasibility of the cut-and-push method as a possible safe alternative to the pullout method for removal of soft PEG devices with a large caliber. Methods Patients with 20 French (Fr) or larger soft PEG system were enrolled for PEG removal by the cut-and-push technique. The replacement catheters were 2 Fr larger than the original ones. Patients were observed at 24 and 72 hours via home nursing care and then weekly for 1 month for signs of intestinal obstruction, tube leakage, or blockage. Results Seventy-nine patients (52 men; mean age 67 years) underwent the procedure: 42 due to leakage and 37 due to blockage. Mean time before tube removal was 4.8 months (range, 3-8). PEG devices were 20 Fr and 24 Fr in 57 (72.2%) and 22 (27.8%) cases, respectively. Collection of the inner component from stool was reported within 48 hours in 63 cases (80%). No cases of intestinal obstruction or other severe adverse events due to the inner component being eliminated throughout the intestine were observed in any patient during the study. Conclusions The cut-and-push method employed for removal of a soft PEG tube with a large caliber seems to be safe and can be performed when removal by external traction may determine the occurrence of peristomal complications or jeopardize PEG replacement.
- Subjects :
- Adult
Male
medicine.medical_specialty
Catheters
medicine.medical_treatment
Home nursing care
Medicine (miscellaneous)
Enteral Nutrition
Swallowing
Percutaneous endoscopic gastrostomy
PEG ratio
Gastroscopy
medicine
Humans
Defecation
Intubation, Gastrointestinal
Device Removal
Aged
Aged, 80 and over
Gastrostomy
Nutrition and Dietetics
medicine.diagnostic_test
business.industry
Middle Aged
Endoscopy
Surgery
Parenteral nutrition
Caliber
Equipment Failure
Female
business
Deglutition Disorders
Subjects
Details
- ISSN :
- 19412452
- Volume :
- 28
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
- Accession number :
- edsair.doi.dedup.....e2295f03ec095203d7578425ce209b63