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TWO HUNDRED CASES OF PERCUTANEOUS TRANSESOPHAGEAL GASTROTUBING (PTEG) FOR THE PATIENTS WITHOUT INDICATION OF PEG

Masato Murakami 1, Keiitirou Nishino 1, Shigeto Murakami 1, Harumi Yano 1, Kaoru Hino 1, Kousuke Mori 1, Kenji Ishido 2, Satoshi Tanabe 2, Mitsuhiro Kida 3, Chika Kusano 2

Affiliations

1 Murakami Memorial Hospital, Saijo, Japan

2 Kitasato University School of Medicine, Sagamihara, Japan

3 Kitasato University, Sagamihara, Japan

Summary

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Abstract

Introduction

Percutaneous transesophageal gastrotubing (PTEG) was established as an alternative route to access the gastrointestinal tract for the patients that Percutaneous Endoscopic Gastrostomy was contraindicated. More than two hundred cases without indication of PEG were rescued by this ideal method.

Aims & Methods

The aim of this study is to evaluate the clinical usefulness of PTEG. A rupture-free balloon (RFB) catheter is inserted into the upper esophagus. Percutaneous balloon puncture with a specialized needle is then performed from the left side of patient’s neck under ultrasonographic control. A guide wire is inserted through the needle into the RFB, followed by a dilator and sheath. A placement tube is then inserted through the sheath, and the sheath is removed. Double Balloons equipped Over tube type RFB were used instead of primary RFB in fifty-seven cases that the puncture needle is punctured into the over tube trough the balloon. We perform PTEG in a total of 204 patients (124 men and 80 women, mean age 71.5 years) PTEG was performed for nutrition in 116 patients and for decompression in 88.Eighty-five patients had peritoneal carcinoma , 62 patients had prior gastrectomy , 30 patients had gastric herniation into the thoracic cavity.

Results

Satisfactory results were achieved in all 204 patients. Median follow-up was 65.0 days in patients who received decompression because of the obstruction due to mainly malignancies and 359.0 days in those who received nutrition. Nine patients who were started in the fluoroscopically assisted according to the original method needed endoscopic assistance to complete the procedure in first 30 cases.
Another 174 patients were performed in endoscopic assistance instead of fluoroscopy.
About the complications, there was 2 patient with severe bleeding requiring blood transfusion, Two patient had tracheal penetration, which was managed conservatively. Other complications were minor oozing bleeding in thirteen patients that did not require blood transfusion, subcutaneous emphysema in two patients, which were managed conservatively. Complication rate was 9.8%. No patient required surgical treatment or died after PTEG.

Conclusion

PTEG is feasible, safe, and useful　for long-term nutrition and/or decompression for the patient who is contraindicated to PEG. PTEG may become the only procedure of the liberation from nasogastric tube for the patient who is contraindicated to PEG. PTEG is the ideal solution for the patients with PEG contraindicated.

Conference

UEG Week Vienna 2024

Topics

Oesophagus

Submission format

Abstract

Session

OESOPHAGEAL, GASTRIC AND DUODENAL (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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