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Evaluation of percutaneous endoscopic feeding tube placement in obese patients.
Nutr Clin Pract. 2009 Dec; 24(6):723-7.NC

Abstract

BACKGROUND

Percutaneous endoscopic feeding tube placement is generally safe and effective for establishing enteral access. In certain subpopulations, such as obese patients, substantial data are limited. This study evaluates the success rate and potential for late complications with placement of feeding tubes in obese patients.

METHODS

The Medical University of South Carolina endoscopy database was queried for adult patients with a body mass index >or=30 kg/m(2) who had undergone percutaneous endoscopic gastrostomy, percutaneous endoscopic gastrojejunostomy, and direct percutaneous jejunostomy placement procedures between the years 2000 and 2006.

RESULTS

Sixty-seven subjects met the inclusion criteria. Percutaneous endoscopic feeding tube placement was successful in 60 of 67 individuals (89.6%) with an average procedure time of 15.5 minutes (range, 5-70 minutes). Postplacement complications occurred in 26 of 59 subjects (44.1%) and included peristomal pain (8.5%), cellulitis (8.5%), inadvertent removal (6.8%), peritubular leak (6.8%), nausea (3.4%), and hemoperitoneum (3.4%). In multivariable logistic regression analysis, weight >250 pounds (>113 kg) predicted a significantly increased likelihood of complications (adjusted odds ratio = 3.86; 95% confidence interval, 1.02-14.57). Other covariates did not significantly affect the complication rate.

CONCLUSIONS

Percutaneous enteral access device placement in obese patients is generally safe, and a body mass index >or=30 kg/m(2) alone should not be a procedural contraindication. Adherence to safe enteral access placement techniques and close periprocedure follow-up should occur in obese patients, especially those weighing >250 pounds (>113 kg). More research is needed to fully evaluate the efficacy of enteral access in this population.

Authors+Show Affiliations

Ochsner Clinic Foundation, Department of Gastroenterology and Hepatology, New Orleans, LA 70121, USA. twiggins@ochsner.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

19955550

Citation

Wiggins, Travis F., et al. "Evaluation of Percutaneous Endoscopic Feeding Tube Placement in Obese Patients." Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, vol. 24, no. 6, 2009, pp. 723-7.
Wiggins TF, Garrow DA, DeLegge MH. Evaluation of percutaneous endoscopic feeding tube placement in obese patients. Nutr Clin Pract. 2009;24(6):723-7.
Wiggins, T. F., Garrow, D. A., & DeLegge, M. H. (2009). Evaluation of percutaneous endoscopic feeding tube placement in obese patients. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 24(6), 723-7. https://doi.org/10.1177/0884533609349250
Wiggins TF, Garrow DA, DeLegge MH. Evaluation of Percutaneous Endoscopic Feeding Tube Placement in Obese Patients. Nutr Clin Pract. 2009;24(6):723-7. PubMed PMID: 19955550.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of percutaneous endoscopic feeding tube placement in obese patients. AU - Wiggins,Travis F, AU - Garrow,Donald A, AU - DeLegge,Mark H, PY - 2009/12/4/entrez PY - 2009/12/4/pubmed PY - 2010/3/30/medline SP - 723 EP - 7 JF - Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition JO - Nutr Clin Pract VL - 24 IS - 6 N2 - BACKGROUND: Percutaneous endoscopic feeding tube placement is generally safe and effective for establishing enteral access. In certain subpopulations, such as obese patients, substantial data are limited. This study evaluates the success rate and potential for late complications with placement of feeding tubes in obese patients. METHODS: The Medical University of South Carolina endoscopy database was queried for adult patients with a body mass index >or=30 kg/m(2) who had undergone percutaneous endoscopic gastrostomy, percutaneous endoscopic gastrojejunostomy, and direct percutaneous jejunostomy placement procedures between the years 2000 and 2006. RESULTS: Sixty-seven subjects met the inclusion criteria. Percutaneous endoscopic feeding tube placement was successful in 60 of 67 individuals (89.6%) with an average procedure time of 15.5 minutes (range, 5-70 minutes). Postplacement complications occurred in 26 of 59 subjects (44.1%) and included peristomal pain (8.5%), cellulitis (8.5%), inadvertent removal (6.8%), peritubular leak (6.8%), nausea (3.4%), and hemoperitoneum (3.4%). In multivariable logistic regression analysis, weight >250 pounds (>113 kg) predicted a significantly increased likelihood of complications (adjusted odds ratio = 3.86; 95% confidence interval, 1.02-14.57). Other covariates did not significantly affect the complication rate. CONCLUSIONS: Percutaneous enteral access device placement in obese patients is generally safe, and a body mass index >or=30 kg/m(2) alone should not be a procedural contraindication. Adherence to safe enteral access placement techniques and close periprocedure follow-up should occur in obese patients, especially those weighing >250 pounds (>113 kg). More research is needed to fully evaluate the efficacy of enteral access in this population. SN - 1941-2452 UR - https://www.unboundmedicine.com/medline/citation/19955550/Evaluation_of_percutaneous_endoscopic_feeding_tube_placement_in_obese_patients_ L2 - https://doi.org/10.1177/0884533609349250 DB - PRIME DP - Unbound Medicine ER -