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Comparison of complication rates, types, and average tube patency between jejunostomy tubes and percutaneous gastrostomy tubes in a regional home enteral nutrition support program.
Nutr Clin Pract. 2015 Jun; 30(3):393-7.NC

Abstract

BACKGROUND

Percutaneous endoscopic gastrostomy (PEG) tubes are common enteral access devices for long-term enteral nutrition. Jejunostomy tubes (J-tubes) are able to provide postpyloric enteral access in patients who are not PEG tube candidates. There is a scarcity of literature comparing complication rates of J-tubes to PEG tubes.

OBJECTIVE

To compare and characterize J-tube and PEG tube complications requiring tube replacement.

METHODS

A retrospective chart review was performed on 560 patients discharged from the Northern Alberta Home Enteral Nutrition Support Program (NAHENSP) from January 2010 to December 2011. Patients were followed for 3 years from initial tube insertion or until discharge from the NAHENSP, whichever was earliest. Comparisons were made in terms of complications requiring tube replacement, tube patency to first replacement, and indications for tube replacement.

RESULTS

A total of 64 J-tube patients were identified and compared with 65 PEG tube patients. Tube replacement rates for the J-tube group included 3.2 cases per 1000 patient days compared with 0.86 cases per 1000 patient days in the PEG group (P < .001). The mean ± SEM duration to first tube replacement for J-tube and PEG tube patients was 160 ± 26.3 days and 331 ± 53.6 days, respectively (P = .010). The most common causes for tube replacement in J-tube patients were dislodgement (35.6%) and obstruction (22.2%) compared with routine replacement (54.5%) and dislodgement (27.2%) in the PEG tube group.

CONCLUSION

J-tubes are associated with higher complication rates requiring tube replacement compared with PEG tubes. The main causes of J-tube replacement are dislodgement and obstruction.

Authors+Show Affiliations

Department of Medicine, Royal Alexandra Hospital, Edmonton, Alberta, Canada ao@ualberta.ca.Epidemiology Coordinating and Research (EPICORE) Centre, University of Alberta, Royal Alexandra Hospital, Edmonton, Alberta, Canada.Division of Gastroenterology, Grey Nuns Hospital, Royal Alexandra Hospital, Edmonton, Alberta, Canada.Division of Gastroenterology, Royal Alexandra Hospital, Edmonton, Alberta, Canada.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25378355

Citation

Ao, Peter, et al. "Comparison of Complication Rates, Types, and Average Tube Patency Between Jejunostomy Tubes and Percutaneous Gastrostomy Tubes in a Regional Home Enteral Nutrition Support Program." Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, vol. 30, no. 3, 2015, pp. 393-7.
Ao P, Sebastianski M, Selvarajah V, et al. Comparison of complication rates, types, and average tube patency between jejunostomy tubes and percutaneous gastrostomy tubes in a regional home enteral nutrition support program. Nutr Clin Pract. 2015;30(3):393-7.
Ao, P., Sebastianski, M., Selvarajah, V., & Gramlich, L. (2015). Comparison of complication rates, types, and average tube patency between jejunostomy tubes and percutaneous gastrostomy tubes in a regional home enteral nutrition support program. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 30(3), 393-7. https://doi.org/10.1177/0884533614554263
Ao P, et al. Comparison of Complication Rates, Types, and Average Tube Patency Between Jejunostomy Tubes and Percutaneous Gastrostomy Tubes in a Regional Home Enteral Nutrition Support Program. Nutr Clin Pract. 2015;30(3):393-7. PubMed PMID: 25378355.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of complication rates, types, and average tube patency between jejunostomy tubes and percutaneous gastrostomy tubes in a regional home enteral nutrition support program. AU - Ao,Peter, AU - Sebastianski,Meghan, AU - Selvarajah,Vijeyakumar, AU - Gramlich,Leah, Y1 - 2014/11/06/ PY - 2014/11/8/entrez PY - 2014/11/8/pubmed PY - 2016/4/26/medline KW - complications KW - enteral nutrition KW - home care services KW - jejunostomy SP - 393 EP - 7 JF - Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition JO - Nutr Clin Pract VL - 30 IS - 3 N2 - BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tubes are common enteral access devices for long-term enteral nutrition. Jejunostomy tubes (J-tubes) are able to provide postpyloric enteral access in patients who are not PEG tube candidates. There is a scarcity of literature comparing complication rates of J-tubes to PEG tubes. OBJECTIVE: To compare and characterize J-tube and PEG tube complications requiring tube replacement. METHODS: A retrospective chart review was performed on 560 patients discharged from the Northern Alberta Home Enteral Nutrition Support Program (NAHENSP) from January 2010 to December 2011. Patients were followed for 3 years from initial tube insertion or until discharge from the NAHENSP, whichever was earliest. Comparisons were made in terms of complications requiring tube replacement, tube patency to first replacement, and indications for tube replacement. RESULTS: A total of 64 J-tube patients were identified and compared with 65 PEG tube patients. Tube replacement rates for the J-tube group included 3.2 cases per 1000 patient days compared with 0.86 cases per 1000 patient days in the PEG group (P < .001). The mean ± SEM duration to first tube replacement for J-tube and PEG tube patients was 160 ± 26.3 days and 331 ± 53.6 days, respectively (P = .010). The most common causes for tube replacement in J-tube patients were dislodgement (35.6%) and obstruction (22.2%) compared with routine replacement (54.5%) and dislodgement (27.2%) in the PEG tube group. CONCLUSION: J-tubes are associated with higher complication rates requiring tube replacement compared with PEG tubes. The main causes of J-tube replacement are dislodgement and obstruction. SN - 1941-2452 UR - https://www.unboundmedicine.com/medline/citation/25378355/Comparison_of_complication_rates_types_and_average_tube_patency_between_jejunostomy_tubes_and_percutaneous_gastrostomy_tubes_in_a_regional_home_enteral_nutrition_support_program_ L2 - https://doi.org/10.1177/0884533614554263 DB - PRIME DP - Unbound Medicine ER -