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DOI: 10.1055/s-0044-1801332
Optimizing Care and Maintenance of Enteric Tubes: Insights into Percutaneous Radiologically Placed Gastrointestinal Luminal Tubes
Abstract
Percutaneous enteric tubes, including gastrostomy, gastrojejunostomy, and percutaneous transesophageal gastrostomy, are essential for patients who cannot maintain adequate oral nutrition or require gastric decompression due to conditions like malignant bowel obstruction. Proper care and maintenance are crucial to prevent complications and maintain function. Enteric tubes are inserted using various techniques at different locations based on patient needs and anatomical considerations. Enteric tubes play a vital role in patient care, and continued research and innovation are necessary to improve outcomes and reduce complications. Routine care involves regular flushing and site maintenance to prevent occlusion and infection. While complications are common, they can be effectively managed or avoided with proper care. This review outlines the care, maintenance protocols, and post-placement complication management for enteric tubes.
Publication History
Article published online:
28 January 2025
© 2025. Thieme. All rights reserved.
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References
- 1 Bannerman E, Pendlebury J, Phillips F, Ghosh S. A cross-sectional and longitudinal study of health-related quality of life after percutaneous gastrostomy. Eur J Gastroenterol Hepatol 2000; 12 (10) 1101-1109
- 2 Ho SG, Marchinkow LO, Legiehn GM, Munk PL, Lee MJ. Radiological percutaneous gastrostomy. Clin Radiol 2001; 56 (11) 902-910
- 3 Lanphere J. Principles of enteral feeding and nutrition. In: Wagner AK, Weppner J. eds. Acute Care Neuroconsultation and Neurorehabilitation Management. Springer International Publishing; 2024: 219-233
- 4 Deitch EA, Winterton J, Li M, Berg R. The gut as a portal of entry for bacteremia. Role of protein malnutrition. Ann Surg 1987; 205 (06) 681-692
- 5 Gauderer MW, Ponsky JL, Izant Jr RJ. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg 1980; 15 (06) 872-875
- 6 Wollman B, D'Agostino HB, Walus-Wigle JR, Easter DW, Beale A. Radiologic, endoscopic, and surgical gastrostomy: an institutional evaluation and meta-analysis of the literature. Radiology 1995; 197 (03) 699-704
- 7 Itkin M, DeLegge MH, Fang JC. et al; Society of Interventional Radiology, 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). Gastroenterology 2011; 141 (02) 742-765
- 8 Chehab MA, Thakor AS, Tulin-Silver S. et al. Adult and pediatric antibiotic prophylaxis during vascular and IR procedures: a Society of Interventional Radiology Practice Parameter Update Endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Association for Interventional Radiology. J Vasc Interv Radiol 2018; 29 (11) 1483-1501.e2
- 9 Shin KH, Shin JH, Song HY, Yang ZQ, Kim JH, Kim KR. Primary and conversion percutaneous gastrojejunostomy under fluoroscopic guidance: 10 years of experience. Clin Imaging 2008; 32 (04) 274-279
- 10 Gray RR, Ho CS, Yee A, Montanera W, Jones DP. Direct percutaneous jejunostomy. AJR Am J Roentgenol 1987; 149 (05) 931-932
- 11 Yang ZQ, Shin JH, Song HY. et al. Fluoroscopically guided percutaneous jejunostomy: outcomes in 25 consecutive patients. Clin Radiol 2007; 62 (11) 1061-1065 , discussion 1066–1068
- 12 van Overhagen H, Ludviksson MA, Laméris JS. et al. US and fluoroscopic-guided percutaneous jejunostomy: experience in 49 patients. J Vasc Interv Radiol 2000; 11 (01) 101-106
- 13 Kim CY, Dai R, Wang Q, Ronald J, Zani S, Smith TP. Jejunostomy tube insertion for enteral nutrition: comparison of outcomes after laparoscopic versus radiologic insertion. J Vasc Interv Radiol 2020; 31 (07) 1132-1138
- 14 Hu HT, Shin JH, Song HY. et al. Fluoroscopically guided percutaneous jejunostomy with use of a 21-gauge needle: a prospective study in 51 patients. J Vasc Interv Radiol 2009; 20 (12) 1583-1587
- 15 Tuca A, Guell E, Martinez-Losada E, Codorniu N. Malignant bowel obstruction in advanced cancer patients: epidemiology, management, and factors influencing spontaneous resolution. Cancer Manag Res 2012; 4: 159-169
- 16 Litwin R.J, Tam AL, Sheth RA. et al. Safety and efficacy of percutaneous transabdominal and transesophageal decompression gastric catheters for palliation of malignant bowel obstruction. Abdom Radiol 2021; 46: 4489-4498
- 17 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
- 18 Norton B, Homer-Ward M, Donnelly MT, Long RG, Holmes GK. A randomised prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding after acute dysphagic stroke. BMJ 1996; 312 (7022): 13-16
- 19 Rotellini-Coltvet L, Wallace A, Saini G. et al. Percutaneous transesophageal gastrostomy: procedural technique and outcomes. J Vasc Interv Radiol 2023; 34 (11) 1901-1907
- 20 Crowley JJ, Cahill AM. Society of Interventional Radiology guidelines and statements division 2020 year-end document review. J Vasc Interv Radiol 2021; 32 (06) 918.e1-918.e4
- 21 Majid HA, Emery PW, Whelan K. Definitions, attitudes, and management practices in relation to diarrhea during enteral nutrition: a survey of patients, nurses, and dietitians. Nutr Clin Pract 2012; 27 (02) 252-260
- 22 Sabir SH, Armstrong R, Elting LS, Wallace MJ, Gupta S, Tam AL. Early initiation of enteral feeding in cancer patients after outpatient percutaneous fluoroscopy-guided gastrostomy catheter placement. J Vasc Interv Radiol 2014; 25 (04) 618-622
- 23 Sutcliffe J, Wigham A, Mceniff N, Dvorak P, Crocetti L, Uberoi R. CIRSE standards of practice guidelines on gastrostomy. Cardiovasc Intervent Radiol 2016; 39 (07) 973-987
- 24 Keithley JK, Swanson B. Enteral nutrition: an update on practice recommendations. Medsurg Nurs 2004; 13 (02) 131-134
- 25 Mateo MA. Nursing management of enteral tube feedings. Heart Lung 1996; 25 (04) 318-323
- 26 Frankel EH, Enow NB, Jackson II KC, Kloiber LL. Methods of restoring patency to occluded feeding tubes. Nutr Clin Pract 1998; 13 (03) 129-131
- 27 Kohn CL. The relationship between enteral formula contamination and length of enteral delivery set usage. JPEN J Parenter Enteral Nutr 1991; 15 (05) 567-571
- 28 Madden A. Handbook of drug administration via enteral feeding tubes. J Hum Nutr Diet 2007; 20 (02) 136-136
- 29 Marcuard SP, Stegall KL, Trogdon S. Clearing obstructed feeding tubes. JPEN J Parenter Enteral Nutr 1989; 13 (01) 81-83
- 30 K970178.pdf. Accessed July 17, 2024 at: https://www.accessdata.fda.gov/cdrh_docs/pdf/K970178.pdf
- 31 Boeykens K, Duysburgh I, Verlinden W. Prevention and management of minor complications in percutaneous endoscopic gastrostomy. BMJ Open Gastroenterol 2022; 9 (01) e000975
- 32 Lin HS, Ibrahim HZ, Kheng JW, Fee WE, Terris DJ. Percutaneous endoscopic gastrostomy: strategies for prevention and management of complications. Laryngoscope 2021; 111 (10) 1847-1852
- 33 McClave SA, Chang WK. Complications of enteral access. Gastrointest Endosc 2003; 58 (05) 739-751
- 34 Covarrubias DA, O'Connor OJ, McDermott S, Arellano RS. Radiologic percutaneous gastrostomy: review of potential complications and approach to managing the unexpected outcome. AJR Am J Roentgenol 2013; 200 (04) 921-931
- 35 Kim JW, Song HY, Kim KR, Shin JH, Choi EK. The one-anchor technique of gastropexy for percutaneous radiologic gastrostomy: results of 248 consecutive procedures. J Vasc Interv Radiol 2008; 19 (07) 1048-1053
- 36 Hoang PT, Menias CO, Niemeyer MM. Percutaneous gastrostomy tube placement: recognizing when things go wrong. Semin Intervent Radiol 2019; 36 (03) 264-274
- 37 Buried bumper syndrome: low incidence and safe endoscopic management - PubMed. Accessed July 30, 2024 at: https://pubmed.ncbi.nlm.nih.gov/21861316/