Percutaneous Transesophageal Gastric Tubes: Indications, Technique, Safety, Efficacy, and Management

Kevin M. Burns; Steven Y. Huang

doi:10.1055/s-0038-1639598

Digestive Disease Interventions, Table of Contents

Digestive Disease Interventions 2018; 02(01): 072-078
DOI: 10.1055/s-0038-1639598

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Percutaneous Transesophageal Gastric Tubes: Indications, Technique, Safety, Efficacy, and Management

Authors

Kevin M. Burns

¹Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Steven Y. Huang

¹Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas

Abstract

Percutaneous transesophageal gastric (PTEG) tube placement is an alternative method of gastric access for feeding or decompression in patients with contraindications to conventional gastrostomy tube placement such as peritoneal carcinomatosis, gastric wall tumors, ascites, or intervening organs. PTEG tube placement is safe with a high technical success rate and it can be placed with supplies available in most interventional radiology departments using ultrasound and fluoroscopic guidance. PTEG tubes are highly efficacious at reducing symptoms in patients with malignant bowel obstruction as an alternative to long-term nasogastric decompression.

Keywords

transesophageal gastric tube - decompression - venting - feeding

Full Text

References

References
1 Felsher J, Chand B, Ponsky J. Decompressive percutaneous endoscopic gastrostomy in nonmalignant disease. Am J Surg 2004; 187 (02) 254-256
2 Taller A, Horvath E, Iliás L. , et al. Technical modifications for improving the success rate of PEG tube placement in patients with head and neck cancer. Gastrointest Endosc 2001; 54 (05) 633-636
3 Han K, Kim MD, Kwon JH. , et al. Randomized controlled trial comparing radiologic pigtail-retained gastrostomy and radiologic mushroom-retained gastrostomy. J Vasc Interv Radiol 2017; 28 (12) 1702-1707
4 Lee MJ, Saini S, Brink JA, Morrison MC, Hahn PF, Mueller PR. Malignant small bowel obstruction and ascites: not a contraindication to percutaneous gastrostomy. Clin Radiol 1991; 44 (05) 332-334
5 Baltz JG, Argo CK, Al-Osaimi AM, Northup PG. Mortality after percutaneous endoscopic gastrostomy in patients with cirrhosis: a case series. Gastrointest Endosc 2010; 72 (05) 1072-1075
6 Udomsawaengsup S, Brethauer S, Kroh M, Chand B. Percutaneous transesophageal gastrostomy (PTEG): a safe and effective technique for gastrointestinal decompression in malignant obstruction and massive ascites. Surg Endosc 2008; 22 (10) 2314-2318
7 Aramaki T, Arai Y, Inaba Y. , et al. Phase II study of percutaneous transesophageal gastrotubing for patients with malignant gastrointestinal obstruction; JIVROSG-0205. J Vasc Interv Radiol 2013; 24 (07) 1011-1017
8 Inoue M, Uchida K, Kawamoto A. , et al. Percutaneous transesophageal gastrostomy (PTEG) placement in an infant. J Pediatr Gastroenterol Nutr 2007; 45 (03) 363-365
9 Okita A, Miyade Y, Okano K. Effective management of an advanced gastric cancer patient by TS-1 combined chemotherapy using nasojejunal tube and successful transfer to home care after percutaneous transesophageal gastro-tubing (PTEG): a case report. Acta Med Okayama 2010; 64 (01) 67-70
10 Oshiro T, Saiki A, Suzuki J. , et al. Percutaneous transesophageal gastro-tubing for management of gastric leakage after sleeve gastrectomy. Obes Surg 2014; 24 (09) 1576-1580
11 Murakami M, Nishino K, Takaoka Y. , et al. Endoscopically assisted percutaneous transesophageal gastrotubing: a retrospective pilot study. Eur J Gastroenterol Hepatol 2013; 25 (08) 989-995
12 Baeten C, Hoefnagels J. Feeding via nasogastric tube or percutaneous endoscopic gastrostomy. A comparison. Scand J Gastroenterol Suppl 1992; 194: 95-98
13 Park RH, Allison MC, Lang J. , et al. Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. BMJ 1992; 304 (6839): 1406-1409
14 Oishi H, Murata J, Kameoka S. [Percutaneous transesophageal gastric-tube drainage--development of the balloon catheter and future prospects] [Article in Japanese]. Nippon Geka Gakkai Zasshi 1998; 99 (04) 275
15 Singal AK, Dekovich AA, Tam AL, Wallace MJ. Percutaneous transesophageal gastrostomy tube placement: an alternative to percutaneous endoscopic gastrostomy in patients with intra-abdominal metastasis. Gastrointest Endosc 2010; 71 (02) 402-406
16 Oishi H, Shindo H, Shirotani N, Kameoka S. A nonsurgical technique to create an esophagostomy for difficult cases of percutaneous endoscopic gastrostomy. Surg Endosc 2003; 17 (08) 1224-1227
17 Mackey R, Chand B, Oishi H, Kameoka S, Ponsky JL. Percutaneous transesophageal gastrostomy tube for decompression of malignant obstruction: report of the first case and our series in the US. J Am Coll Surg 2005; 201 (05) 695-700
18 Toh Yoon EW, Nishihara K. Percutaneous transesophageal gastro-tubing (PTEG) as an alternative long-term tube feeding procedure when gastrostomy is not feasible. Therap Adv Gastroenterol 2017; 10 (12) 911-917
19 Toh Yoon EW. Esophagostomy for percutaneous tube feeding in diaphragm paralysis. Clin Case Rep 2016; 4 (03) 305-306
20 Yamamoto T, Enomoto T, Matsumura A. Percutaneous transesophageal gastrotubing: alternative tube nutrition for a patient with a ventriculoperitoneal shunt. Surg Neurol 2009; 72 (03) 278-279 , discussion 280
21 Oshiro T, Oishi H, Okazumi S, Katoh R. Percutaneous transesophageal gastro-tubing: a new treatment strategy for gastric leakage after sleeve gastrectomy. J Obes Weight Loss Ther 2017;7(3)
22 Patel IJ, Davidson JC, Nikolic B. , et al; Standards of Practice Committee, with Cardiovascular and Interventional Radiological Society of Europe (CIRSE) Endorsement. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 2012; 23 (06) 727-736
23 Paquette CM, Manos DC, Psooy BJ. Unilateral vocal cord paralysis: a review of CT findings, mediastinal causes, and the course of the recurrent laryngeal nerves. Radiographics 2012; 32 (03) 721-740
24 Chan D, Downing D, Keough CE. , et al; Society of Interventional Radiology; Association of periOperative Registered Nurses. Joint Practice Guideline for Sterile Technique during Vascular and Interventional Radiology Procedures: From the Society of Interventional Radiology, Association of periOperative Registered Nurses, and Association for Radiologic and Imaging Nursing, for the Society of Interventional Radiology [corrected] Standards of Practice Committee, and Endorsed by the Cardiovascular Interventional Radiological Society of Europe and the Canadian Interventional Radiology Association. J Vasc Interv Radiol 2012; 23 (12) 1603-1612
25 Itkin M, DeLegge MH, Fang JC. , et al; Interventional Radiology and American Gastroenterological Association; American Gastroenterological Association Institute; Canadian Interventional Radiological Association; Cardiovascular and Interventional Radiological Society of Europe. Multidisciplinary practical guidelines for gastrointestinal access for enteral nutrition and decompression from the Society of Interventional Radiology and American Gastroenterological Association (AGA) Institute, with endorsement by Canadian Interventional Radiological Association (CIRA) and Cardiovascular and Interventional Radiological Society of Europe (CIRSE). J Vasc Interv Radiol 2011; 22 (08) 1089-1106
26 Shastri YM, Hoepffner N, Tessmer A, Ackermann H, Schroeder O, Stein J. New introducer PEG gastropexy does not require prophylactic antibiotics: multicenter prospective randomized double-blind placebo-controlled study. Gastrointest Endosc 2008; 67 (04) 620-628
27 Scheidbach H, Horbach T, Groitl H, Hohenberger W. Percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) for decompression in the upper gastrointestinal tract. Initial experience with palliative treatment of gastrointestinal obstruction in terminally ill patients with advanced carcinomas. Surg Endosc 1999; 13 (11) 1103-1105
28 Larson DE, Burton DD, Schroeder KW, DiMagno EP. Percutaneous endoscopic gastrostomy. Indications, success, complications, and mortality in 314 consecutive patients. Gastroenterology 1987; 93 (01) 48-52
29 Huang SY, Engstrom BI, Lungren MP, Kim CY. Management of dysfunctional catheters and tubes inserted by interventional radiology. Semin Intervent Radiol 2015; 32 (02) 67-77
30 Ripamonti CI, Easson AM, Gerdes H. Management of malignant bowel obstruction. Eur J Cancer 2008; 44 (08) 1105-1115
31 Shaw C, Bassett RL, Fox PS. , et al. Palliative venting gastrostomy in patients with malignant bowel obstruction and ascites. Ann Surg Oncol 2013; 20 (02) 497-505
32 Brooksbank MA, Game PA, Ashby MA. Palliative venting gastrostomy in malignant intestinal obstruction. Palliat Med 2002; 16 (06) 520-526