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Fluoroscopy-guided percutaneous gastrostomy with pull technique for the amyotrophic lateral sclerosis patients with very low vital capacity.

Authors
 Jung Hyun Park  ;  Seong-Woong Kang  ;  Jong Yun Won  ;  Chang Wook Uhm 
Citation
 JOURNAL OF PARENTERAL AND ENTERAL NUTRITION, Vol.34(4) : 421-425, 2010 
Journal Title
 JOURNAL OF PARENTERAL AND ENTERAL NUTRITION 
ISSN
 0148-6071 
Issue Date
2010
MeSH
Adult ; Aged ; Amyotrophic Lateral Sclerosis/physiopathology ; Amyotrophic Lateral Sclerosis/surgery* ; Female ; Fluoroscopy/methods ; Gastrostomy/methods* ; Humans ; Male ; Middle Aged ; Stomach/surgery* ; Treatment Outcome ; Vital Capacity*
Abstract
BACKGROUND: The purpose of this study was to evaluate the safety and usefulness of fluoroscopy-guided percutaneous gastrostomy (FPG) in patients with amyotrophic lateral sclerosis (ALS) using a large-profile gastrostomy tube accompanied by the pull technique. This procedure was done without an accompanying endoscopy or gastropexy. METHODS: Thirty-six patients with ALS underwent FPG using a large-profile gastrostomy tube accompanied by the pull technique. A 24 Fr pull-type tube was inserted under fluoroscopic guidance into the mouth and pulled to the upper-abdominal puncture site using a snare. The technical success rate, occurrence of complications, and clinical outcomes were evaluated. RESULTS: The technical success rate was 100%. There were no procedure-related mortalities or respiratory complications. The mean forced vital capacity of the patients was 732 mL (17.7% of the normal predicted value). During the procedure, 16 patients required ventilator support by nasal mask or tracheostomy. The tube indwelling period ranged from 1 to 24 months (average, 9.3). During this period, all the tubes were maintained in a proper position. In 18 patients, the tube was exchanged after 6 months without any problems. CONCLUSIONS: The FPG procedure using a 24 Fr tube and the pull technique shows a high rate of technical success. This procedure has a low risk for respiratory complications because endoscopic guidance is not needed. In addition, gastropexy is not required, which allows a large-profile catheter to be inserted during a single procedure.
Full Text
http://pen.sagepub.com/content/34/4/421
DOI
10.1177/0148607110362528
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seong Woong(강성웅) ORCID logo https://orcid.org/0000-0002-7279-3893
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101297
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