Document Detail


Gastrostomy tube placement by endoscopy versus radiologic methods in patients with ALS: A retrospective study of complications and outcome.
MedLine Citation:
PMID:  23286755     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Gastrostomy tube placement for malnutrition and weight loss stabilization occurs in many patients with ALS. We sought to compare the outcome and complications of gastrostomy tube placement by endoscopic (PEG) and multiple radiologic (RIG) methods in ALS patients. A retrospective analysis was conducted on all ALS patients evaluated at Northwestern University who received gastrostomy tubes between January 2009 and March 2012. One hundred and eight gastrostomy tube attempts were made on a total of 100 different patients. Failed gastrostomy tube placement occurred in 15.7% of PEGs and 1.9% of RIGs. Post-procedure aspiration was recognized after 10.5% PEG and 0 RIG attempts. Multivariate analysis revealed a linear increase in risk of post-procedure aspiration for every increase in ALSFRS swallow score. No statistically significant differences in failure or complications were observed when comparing two different methods of RIG (push-type vs. pull-type). Our findings support gastrostomy tube placement by radiographic methods in ALS patients. Gastrostomy tube placement by RIG was more often successful and less often associated with aspiration. Our findings add to the growing body of literature that argues for early gastrostomy tube placement in young patients with prominent bulbar involvement.
Authors:
Jeffrey A Allen; Richard Chen; Senda Ajroud-Driss; Robert L Sufit; Scott Heller; Teepu Siddique; Lisa Wolfe
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-4
Journal Detail:
Title:  Amyotrophic lateral sclerosis and frontotemporal degeneration     Volume:  -     ISSN:  2167-9223     ISO Abbreviation:  Amyotroph Lateral Scler Frontotemporal Degener     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101587185     Medline TA:  Amyotroph Lateral Scler Frontotemporal Degener     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Neurology, Division of Neuromuscular Medicine, Northwestern University, Feinberg School of Medicine , Chicago.
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