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Operation of the percutaneous endoscopic gastrostomy-jejunostomy tube without endoscopy in patients with Parkinson’s disease on levodopa-carbidopa intestinal gel infusion therapy
INTRODUCTION: Tube-related adverse events (AEs) occur frequently in patients with Parkinson’s disease (PD) receiving levodopa-carbidopa intestinal gel therapy. Endoscopy has become evasive since the beginning of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to evaluate methods t...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298846/ https://www.ncbi.nlm.nih.gov/pubmed/34316657 http://dx.doi.org/10.1016/j.prdoa.2020.100079 |
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author | Mukai, Yohei Toyoda, Hiroyuki Miyama, Kenji Takahashi, Yuji |
author_facet | Mukai, Yohei Toyoda, Hiroyuki Miyama, Kenji Takahashi, Yuji |
author_sort | Mukai, Yohei |
collection | PubMed |
description | INTRODUCTION: Tube-related adverse events (AEs) occur frequently in patients with Parkinson’s disease (PD) receiving levodopa-carbidopa intestinal gel therapy. Endoscopy has become evasive since the beginning of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to evaluate methods that use the percutaneous endoscopic gastrostomy-jejunostomy (PEG-J) tubes without endoscopy. METHODS: We included 19 patients in this study. The contrast agent was injected into the PEG-J tube to clarify the AEs related to the use of the tube. When the kink of the PEG-J tube was found, it was pulled approximately 5–10 cm. When placing or replacing the PEG-J tube, the percutaneous endoscopic gastrostomy (PEG) tube was pushed into the gastrostomy hole to bring its tip closer to the pylorus before a new PEG-J tube was inserted into it. RESULTS: The mean patient age was 63.1 ± 9.9 years, while the mean duration of PD was 16.7 ± 6.3 years. Tube-related AEs included PEG-J tube kinks (32 events), connector failures (20 events), and PEG-J tube entanglements without/with bezoars (9 events/5 events). All PEG-J tube kinks were resolved by tube manipulation with a fluoroscopic guide. In 66 of 85 events (77.6%), the PEG-J tube was placed or replaced without endoscopy. We believe that the use of the antispasmodic agent just before PEG-J operation reduced this rate. CONCLUSION: Our methods were able to resolve most AEs associated with PEG-J tube use without endoscopy. |
format | Online Article Text |
id | pubmed-8298846 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-82988462021-07-26 Operation of the percutaneous endoscopic gastrostomy-jejunostomy tube without endoscopy in patients with Parkinson’s disease on levodopa-carbidopa intestinal gel infusion therapy Mukai, Yohei Toyoda, Hiroyuki Miyama, Kenji Takahashi, Yuji Clin Park Relat Disord Short Communication INTRODUCTION: Tube-related adverse events (AEs) occur frequently in patients with Parkinson’s disease (PD) receiving levodopa-carbidopa intestinal gel therapy. Endoscopy has become evasive since the beginning of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to evaluate methods that use the percutaneous endoscopic gastrostomy-jejunostomy (PEG-J) tubes without endoscopy. METHODS: We included 19 patients in this study. The contrast agent was injected into the PEG-J tube to clarify the AEs related to the use of the tube. When the kink of the PEG-J tube was found, it was pulled approximately 5–10 cm. When placing or replacing the PEG-J tube, the percutaneous endoscopic gastrostomy (PEG) tube was pushed into the gastrostomy hole to bring its tip closer to the pylorus before a new PEG-J tube was inserted into it. RESULTS: The mean patient age was 63.1 ± 9.9 years, while the mean duration of PD was 16.7 ± 6.3 years. Tube-related AEs included PEG-J tube kinks (32 events), connector failures (20 events), and PEG-J tube entanglements without/with bezoars (9 events/5 events). All PEG-J tube kinks were resolved by tube manipulation with a fluoroscopic guide. In 66 of 85 events (77.6%), the PEG-J tube was placed or replaced without endoscopy. We believe that the use of the antispasmodic agent just before PEG-J operation reduced this rate. CONCLUSION: Our methods were able to resolve most AEs associated with PEG-J tube use without endoscopy. Elsevier 2020-11-17 /pmc/articles/PMC8298846/ /pubmed/34316657 http://dx.doi.org/10.1016/j.prdoa.2020.100079 Text en © 2020 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Short Communication Mukai, Yohei Toyoda, Hiroyuki Miyama, Kenji Takahashi, Yuji Operation of the percutaneous endoscopic gastrostomy-jejunostomy tube without endoscopy in patients with Parkinson’s disease on levodopa-carbidopa intestinal gel infusion therapy |
title | Operation of the percutaneous endoscopic gastrostomy-jejunostomy tube without endoscopy in patients with Parkinson’s disease on levodopa-carbidopa intestinal gel infusion therapy |
title_full | Operation of the percutaneous endoscopic gastrostomy-jejunostomy tube without endoscopy in patients with Parkinson’s disease on levodopa-carbidopa intestinal gel infusion therapy |
title_fullStr | Operation of the percutaneous endoscopic gastrostomy-jejunostomy tube without endoscopy in patients with Parkinson’s disease on levodopa-carbidopa intestinal gel infusion therapy |
title_full_unstemmed | Operation of the percutaneous endoscopic gastrostomy-jejunostomy tube without endoscopy in patients with Parkinson’s disease on levodopa-carbidopa intestinal gel infusion therapy |
title_short | Operation of the percutaneous endoscopic gastrostomy-jejunostomy tube without endoscopy in patients with Parkinson’s disease on levodopa-carbidopa intestinal gel infusion therapy |
title_sort | operation of the percutaneous endoscopic gastrostomy-jejunostomy tube without endoscopy in patients with parkinson’s disease on levodopa-carbidopa intestinal gel infusion therapy |
topic | Short Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298846/ https://www.ncbi.nlm.nih.gov/pubmed/34316657 http://dx.doi.org/10.1016/j.prdoa.2020.100079 |
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