The Pharyngostomy Tube: Indications, Technique, Efficacy, and Safety in Modern Surgical Practice

2016 ◽  
Vol 66 (05) ◽  
pp. 390-395
Author(s):  
Jonathan Berger ◽  
Rafael Andrade ◽  
Eitan Podgaetz ◽  
Rafael Garza-Castillon
Keyword(s):  
Tube Placement ◽  
Nasogastric Tubes ◽  
Tube Removal ◽  
Gastric Decompression ◽  
Enteral Access ◽  
The Mean ◽  
Nasogastric Tube Placement ◽  
Mean Time ◽  
Straightforward Approach

Background Long-term nasogastric tubes are uncomfortable and associated with complications such as impairment with speech and swallowing, septum trauma, epistaxis, alar necrosis, and intubation of the trachea among others. Pharyngostomy tubes (PTs) are an alternative for prolonged enteral feeding, transluminal drainage of collections, and gastric decompression in patients with an intestinal obstruction and an inoperable abdomen. Patients and Methods This is a retrospective analysis of patients who had a PT placed at our institution from May 2005 to March 2015. The primary end point of the study was to establish the type and rate of complications and aspiration events related to PT use. Results During the specified period, a total of 84 PTs were placed. The most common indication for PT placement was enteric decompression in 65 (77.4%), followed by transluminal collection drainage in 12 (14.3%), and enteral access for nutrition in 7 (8.3%) patients. The mean time to tube removal was 17.8 days ± 17.1 (range, 2–119). We encountered 10 (11.2%) complications related to PT placement, including 7 cases of cellulitis, 2 superficial abscesses, and 1 patient with pharyngeal hemorrhage. Conclusion PTs are a relatively simple, safe, and straightforward approach to achieve long-term enteral decompression, access for feeding or transluminal drainage, avoiding the complications associated with prolonged nasogastric tube placement. The complication rate is low and patient satisfaction and compliance appear to be higher than with nasogastric tubes. Modern surgeons should be familiar with the procedure and technique. PTs should be part of every surgeon's armamentarium.

Nasendoscopically-assisted placement of a nasogastric feeding tube

1999 ◽  
Vol 113 (9) ◽  
pp. 839-840 ◽  
Author(s):  
Gerard Kelly ◽  
Patrick Lee
Keyword(s):  
Parenteral Nutrition ◽  
Nasogastric Tube ◽  
Feeding Tube ◽  
Oral Feeding ◽  
Tube Placement ◽  
Nasogastric Feeding ◽  
Nasogastric Tubes ◽  
Term Administration ◽  
Enteral Access ◽  
Nasogastric Tube Placement

AbstractNasogastric tube placement is desirable for the short-term administration of calories when oral feeding is not possible. Enteral nutrition is superior to parenteral nutrition. In some patients this method of feeding is impossible because of repeated failure of nasogastric tube placement, necessitating either general anaesthesia for enteral access, or total parenteral nutrition. We describe a new method for nasogastric tube placement aided by a fibre-optic nasendoscope which has resulted in the successful placement of over 20 nasogastric tubes in our unit and the avoidance of more invasive methods of establishing nutrition with their associated complications.

scholarly journals Surveillance System in Smart Cities: A Dependability Evaluation Based on Stochastic Models

Electronics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 876
Author(s):  
Igor Gonçalves ◽  
Laécio Rodrigues ◽  
Francisco Airton Silva ◽  
Tuan Anh Nguyen ◽  
Dugki Min ◽  
...  
Keyword(s):  
Surveillance System ◽  
Smart Cities ◽  
Heterogeneous Data ◽  
Time To Failure ◽  
Video Streams ◽  
Dependability Evaluation ◽  
The Mean ◽  
Mean Time ◽  
The Internet Of Things

Surveillance monitoring systems are highly necessary, aiming to prevent many social problems in smart cities. The internet of things (IoT) nowadays offers a variety of technologies to capture and process massive and heterogeneous data. Due to the fact that (i) advanced analyses of video streams are performed on powerful recording devices; while (ii) surveillance monitoring services require high availability levels in the way that the service must remain connected, for example, to a connection network that offers higher speed than conventional connections; and that (iii) the trust-worthy dependability of a surveillance system depends on various factors, it is not easy to identify which components/devices in a system architecture have the most impact on the dependability for a specific surveillance system in smart cities. In this paper, we developed stochastic Petri net models for a surveillance monitoring system with regard to varying several parameters to obtain the highest dependability. Two main metrics of interest in the dependability of a surveillance system including reliability and availability were analyzed in a comprehensive manner. The analysis results show that the variation in the number of long-term evolution (LTE)-based stations contributes to a number of nines (#9s) increase in availability. The obtained results show that the variation of the mean time to failure (MTTF) of surveillance cameras exposes a high impact on the reliability of the system. The findings of this work have the potential of assisting system architects in planning more optimized systems in this field based on the proposed models.

P14.67 Long-term results of gamma knife radiosurgery for treatment of intracranial glomus jugulare tumors

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii50-ii51
Author(s):  
R M Emad Eldin ◽  
K M Abdel Karim ◽  
A M N El-Shehaby ◽  
W A Reda ◽  
A M Nabeel ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Gamma Knife ◽  
Tumor Volume ◽  
Gamma Knife Radiosurgery ◽  
Long Term Results ◽  
Glomus Jugulare ◽  
The Mean ◽  
Mean Time

Abstract BACKGROUND Glomus Jugulare tumors are benign but locally aggressive ones that represent a therapeutic challenge. Previous studies about the use of Gamma Knife Radiosurgery (GRS) in those tumors have documented good results that needed larger number of patients and longer follow up periods to be confirmed. MATERIAL AND METHODS Between August 2001 and December 2017, 70 patients with glomus jugulare tumors were treated at the Gamma Knife Center, Cairo. They were 46 females and 24 males. The mean age was 48 years (16–71 years). Nineteen of these patients were previously operated, 5 were partially embolized, 3 underwent embolization and subsequent surgery and 43 had gamma knife as their primary treatment. Volume-staged gamma knife radiosurgery was used in 10 patients and single-session in 60 patients, with a total of 86 sessions. The mean target volume was 12.7 cm3 (range 0.2 to 34.5 cm3). The mean tumor volume was 15.5 cm3 (range 0.2 to 105 cm3). The mean prescription dose was 14.5 Gy (range 12 to 18 Gy). RESULTS The mean follow up period was 60 months (range 18 to 206 months), and by the time of the data analysis, two of the patients were dead (66 and 24 months after GK treatment). The tumor control was 98.6% (69/70). Thirty-two tumors became smaller and 37 were unchanged. The symptoms improved in 36 patients, were stable in 32 patients, and worsened in 2 patients who developed a transient facial palsy and worsened hearing. Symptomatic improvement began before any reduction in tumor volume could be detected, where the mean time to clinical improvement was 7 months whereas the mean time to tumor shrinkage was 18 months. CONCLUSION This study about the long term follow up of the GKR for the intracranial glomus jugulare tumors confirmed that this is a highly effective and safe treatment. This data shows that the clinical improvement is not correlated with the radiological volume reduction.

The use of deslorelin implants for the long-term contraception of lionesses and tigers

2008 ◽  
Vol 35 (6) ◽  
pp. 525 ◽  
Author(s):  
H. J. Bertschinger ◽  
M. A. de Barros Vaz Guimarães ◽  
T. E. Trigg ◽  
A. Human
Keyword(s):  
South Africa ◽  
Effective Means ◽  
Panthera Leo ◽  
Ovarian Activity ◽  
Panthera Tigris ◽  
Field Observations ◽  
The Mean ◽  
Free Ranging ◽  
Mean Time

Contraception is an essential tool for controlling reproduction in captive and free-ranging lions. This paper describes the treatment and contraception of 23 captive and 40 free-ranging lionesses (Panthera leo) and four captive tigers (Panthera tigris) in South Africa using 3 × 4.7 mg, 2 × 4.7 mg, 9.4 mg or 4.7 + 9.4 mg deslorelin implants. Thirty-one lionesses were treated more than once at 11- to 60-month intervals. In Brazil, two lionesses were treated with 9.4-mg implants and faecal progesterone and oestradiol concentrations were monitored for 920 days. All combinations of deslorelin showed the length of contraception to be around 30 months with one 3 × 4.7 mg treatment lasting 40 months in one captive lioness. The mean time taken to reconception was 30.1 months for the 3 × 4.7 mg combination. The faecal analyses of the lionesses in Brazil reflected quiescent ovarian activity for periods of 17 and 30 months, respectively, when small oestradiol peaks but no progesterone peaks started to appear. This confirmed the field observations in South Africa. No side effects occurred although several of the lionesses were treated repeatedly for up to 8 years. Deslorelin (Suprelorin) is a safe and effective means of controlling reproduction in captive or free-ranging populations of lions. Where contraception is to be maintained, the implementation of implants at 24-month intervals is recommended.

Percutaneous Fasciotomy for Dupuytren’s Contracture

1997 ◽  
Vol 22 (4) ◽  
pp. 521-522 ◽  
Author(s):  
R. A. DUTHIE ◽  
R. B. CHESNEY
Keyword(s):  
Long Term Results ◽  
Dupuytren’S Contracture ◽  
Dupuytren's Contracture ◽  
The Mean ◽  
Mean Time ◽  
Palmar Skin

Percutaneous fasciotomy has long been established as a treatment for Dupuytren’s contracture. There have been no studies to date of the long-term results of this procedure. We followed up a group of 82 patients 10 years after operation in 1981 and 1982. Thirty-four per cent had had no further surgery. The mean time to further surgery in the rest was 60.4 months. Splitting of the palmar skin which healed with regular dressings occurred in three cases. No other complications were noted. Percutaneous fasciotomy can produce lasting improvement in patients with Dupuytren’s contracture and still has an important role in their overall management.

Examining the Safety of Nasogastric Tube Placement after Endoscopic Sinus Surgery

1998 ◽  
Vol 107 (8) ◽  
pp. 662-664 ◽  
Author(s):  
Neil Bhattacharyya ◽  
Harsha V. Gopal
Keyword(s):  
Nasogastric Tube ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Tube Placement ◽  
Nasogastric Intubation ◽  
Nasogastric Tubes ◽  
Fresh Cadaver ◽  
Nasogastric Tube Placement

Several cases of intracranial injury during the placement of nasogastric tubes have been reported, usually in the setting of anterior skull base fractures. The fovea ethmoidalis and sphenoid sinus are often exposed after endoscopic sinus surgery, so that these structures are potentially placed in the line of contact during nasogastric tube placement. In order to evaluate the ability of the fovea ethmoidalis and roof of the sphenoid sinus to withstand penetration from possible contact during nasogastric tube placement, 12 fresh cadaver heads were studied. After complete endoscopic ethmoidectomy and wide sphenoidotomy, standard 18F and 16F nasogastric tubes were inserted to produce deliberate direct contact with both the fovea ethmoidalis and the sphenoid sinus roof. No penetrations of the fovea occurred in 20 specimen sides with the 18F tube; penetration did occur with the 16F tube in 1 of 13 sides (7.7%). With respect to the sphenoid sinus, no intracranial penetrations occurred in 16 and 11 sides for the 18F and 16F tubes, respectively. The sphenoid sinus was easily entered even in the presence of an intact middle turbinate. These data suggest that although intracranial penetration during nasogastric intubation after endoscopic sinus surgery is an unlikely event, there is a non-negligible risk of such injury. Nasogastric intubation should be performed with caution in patients with a history of sinus surgery.

scholarly journals Buried Bumper Syndrome Revisited: A Rare but Potentially Fatal Complication of PEG Tube Placement

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Saptarshi Biswas ◽  
Sujana Dontukurthy ◽  
Mathew G. Rosenzweig ◽  
Ravi Kothuru ◽  
Sunil Abrol
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Gastric Wall ◽  
Late Complications ◽  
Tube Placement ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Delayed Complications ◽  
Buried Bumper Syndrome ◽  
Peg Tube

Percutaneous endoscopic gastrostomy (PEG) has been used for providing enteral access to patients who require long-term enteral nutrition for years. Although generally considered safe, PEG tube placement can be associated with many immediate and delayed complications. Buried bumper syndrome (BBS) is one of the uncommon and late complications of percutaneous endoscopic gastrostomy (PEG) placement. It occurs when the internal bumper of the PEG tube erodes into the gastric wall and lodges itself between the gastric wall and skin. This can lead to a variety of additional complications such as wound infection, peritonitis, and necrotizing fasciitis. We present here a case of buried bumper syndrome which caused extensive necrosis of the anterior abdominal wall.

scholarly journals Clinical features and outcomes of bowel perforation in primary pediatric gastrointestinal lymphoma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiayu Yan ◽  
Yanlong Duan ◽  
Tingting Liu ◽  
Jianlin Guo ◽  
Chunhui Peng ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Bowel Perforation ◽  
Outpatient Department ◽  
Gastrointestinal Lymphoma ◽  
Long Term Follow Up ◽  
The Mean ◽  
Mean Time ◽  
Prompt Diagnosis

Abstract Background Whether surgery can improve the prognosis of patients with primary pediatric gastrointestinal lymphoma (PPGL) who experienced bowel perforation remains controversial. This study aimed to evaluate the prognosis of such patients. Methods Nine patients pathologically diagnosed with PPGL who experienced perforation at our center between January 2010 and December 2020 were enrolled and divided into two groups: those with perforation during (n = 4) and before (n = 5) chemotherapy. Their medical records were reviewed, and long-term follow-up was conducted by telephone in February 2021. Results All patients with perforation during chemotherapy were diagnosed with PPGL in the outpatient department. The mean time from outpatient visit to chemotherapy was 17.3 ± 6.1 days. Two patients experienced perforation during the first chemotherapy regimen and received conservative treatment, while the others developed perforation after multiple chemotherapy regimens and underwent surgery. All of the patients received regular chemotherapy and survived for a mean follow-up time of 3.8 ± 1.9 years. No patient with perforation before chemotherapy had a definite diagnosis in the outpatient department. Among these patients, 4 experienced perforation and underwent surgery, of whom 3 developed perforation-related complications and died; the other recurred after chemotherapy. Only the patient who received conservative treatment was diagnosed with PPGL before chemotherapy, received regular chemotherapy, and survived without a recurrence for 1.0 year. Conclusion Prompt diagnosis and chemotherapy improve the prognosis of PPGL. Surgery does not affect the prognosis of patients with perforation during chemotherapy but may accelerate disease progression in patients with perforation before chemotherapy.

Comparison of nasogastric tube securing methods and tube types in medical intensive care patients

1995 ◽  
Vol 4 (3) ◽  
pp. 198-203 ◽  
Author(s):  
SM Burns ◽  
M Martin ◽  
V Robbins ◽  
T Friday ◽  
M Coffindaffer ◽  
...  
Keyword(s):  
Intensive Care ◽  
Nasogastric Tube ◽  
Convenience Sample ◽  
Intensive Care Patients ◽  
Medication Delivery ◽  
Nasogastric Tubes ◽  
Gastric Tubes ◽  
Medical Intensive Care ◽  
The Mean ◽  
Mean Time

BACKGROUND: Nasogastric tube displacement can result in serious complications such as aspiration and inadvertent migration of the tube into the lungs. Replacement of the tubes is costly, time- and effort-intensive, uncomfortable for the patients, and potentially dangerous. OBJECTIVE: To determine the best of three methods for securing nasogastric tubes in a medical intensive care population and to identify variables related to the failure of tube securing methods. METHODS: A convenience sample of 103 patients requiring duodenal or standard gastric tubes for feeding, medication delivery, or decompression were randomly assigned to one of three taping methods: pink tape, clear tape, or "butterfly," for a total of 264 taping episodes. Data collection included the mean time until failure of the securing methods as well as variables such as patient alertness and mobility. RESULTS: The mean time until failure was 100 hours with pink tape versus 56 hours with clear tape and 30 hours with the "butterfly." Differences were significant. Duodenal tubes stayed secured longer than standard sump tubes (mean time until failure was 86 vs 41 hours) for all taping methods, but not significant relationship was demonstrated between mean time until failure and variables such as alertness, sedation, confusion, mobility, and the use of restraints. CONCLUSION: Our results showed that the pink tape method was superior. Nasogastric tube securing methods in adult critical care patients vary in efficacy and should be selected carefully.

Use of circular external skeletal fixator constructs to stabilize tarsometatarsal arthrodeses in three dogs

2004 ◽  
Vol 17 (04) ◽  
pp. 204-209 ◽  
Author(s):  
D. D. Lewis ◽  
R. W. Jones ◽  
R. C. Hill ◽  
G. M. Anderson ◽  
K. B. Halling
Keyword(s):  
Functional Outcome ◽  
Weight Bearing ◽  
Antibiotic Administration ◽  
Systemic Antibiotic ◽  
The Mean ◽  
Mean Time

SummaryThis report describes the use of circular external skeletal fixator (CESF) constructs for the stabilization of unilateral tarsometatarsal arthrodeses in three dogs with traumatic intertarsal or tarsometatarsal fracture/luxation injuries. The application of the CESF was performed following a limited approach to the intertarsal and tarsometatarsal joints. All three of the dogs developed post-operative wire tract inflammation with drainage and two dogs developed osteomyelitis. These complications resolved with systemic antibiotic administration, debridement, and/or wire removal, after which all of the dogs tolerated the CESF well and resumed weight-bearing on the affected limb. The mean time to CESF removal was 16 weeks. The CESF construct provided sufficient stabilization for progressive union of the tarsometatarsal arthrodeses with a good long-term functional outcome in all three of the dogs.

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