Abstract

Background

The purpose of this study was to describe our experience with percutaneous transesophageal enteral feeding tube placement when percutaneous gastrostomy tube placement is not feasible.

Materials and Methods

A retrospective review was performed from July 2018 to March 2019. Thirteen patients (9 females, 4 males), (age range 22–80 years; mean age, 55 years; mean body mass index of 24.6) underwent placement of 14 percutaneous transesophageal enteral feeding tubes. Relative contraindications to standard gastrostomy tube placement included: prior gastric surgery (5 patients), severe contractures/large body habitus (2), abdominal mesh (1), high riding stomach (1), interposition of bowel (1), ascites (1), and refractory gastrostomy tract leak (1). Patients were evaluated for functionality of the tube, complications, and patients’ satisfaction with physical examination at 24 h, review of electronic medical record and phone interviews at 1 month, and 3-month follow-up. Complications were classified according to the CIRSE guidelines.

Results

Technical success rate was 100% with placement of seven percutaneous transesophageal gastrostomy tubes and seven percutaneous transesophageal jejunostomy tubes. One patient underwent tube placement twice after dislodgement. At 3-month follow-up, two patients had died, one patient was lost to follow-up, and 11 patients had properly working tubes. No major complications occurred. Minor complication rate was 43% (6/14). Patient’s satisfaction scores ranged from “poor” 2/11 (18%) or “neutral” 4/11 (36.4%) to “satisfied/very satisfied” 5/11 (45.3%).

Conclusion

Percutaneous transesophageal enteral feeding tube placement is feasible with a low complication rate. A majority of patients were either satisfied or neutral with the transesophageal enteral tube.

中文翻译：

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经皮经食道进入肠内喂养管

摘要

背景

这项研究的目的是描述在不可行经皮胃造口术管放置时经皮食管肠内喂养管放置的经验。

材料和方法

回顾性研究从2018年7月至2019年3月进行。对13例患者（9例女性，4例男性）（年龄范围22-80岁；平均年龄：55岁；平均体重指数为24.6）进行了14例经皮食管经肠腔内放置喂食管。标准胃造口管放置的相对禁忌症包括：胃癌手术前（5例），严重挛缩/大型体位（2），腹部网状（1），上腹胃（1），肠管插入（1），腹水（1） ），以及难治性胃造口道渗漏（1）。在24小时时评估患者的试管功能，并发症以及患者对体检的满意度，在1个月时检查电子病历和电话访谈以及3个月的随访。根据CIRSE指南对并发症进行分类。

结果

放置七个经皮食管胃造瘘管和七个经皮食管空肠造口管的技术成功率为100％。一名患者在脱位后接受了两次管置。在3个月的随访中，有2例患者死亡，1例失去随访，11例患者的管子正常工作。无重大并发症发生。轻微并发症发生率为43％（6/14）。患者的满意度得分范围从“差” 2/11（18％）或“中立” 4/11（36.4％）到“满意/非常满意” 5/11（45.3％）。

结论

经皮食管肠内喂养管的置入可行，并发症发生率低。大多数患者对经食道肠管感到满意或中立。