American Society for Gastrointestinal Endoscopy guideline on gastrostomy feeding tubes: methodology and review of evidence

This article from the American Society for Gastrointestinal Endoscopy (ASGE) provides a full description of the methodology used to inform the final guidance outlined in the accompanying summary and recommendations article for strategies to manage endoscopically placed gastrostomy tubes. This article was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and specifically addresses the utility of PEG versus interventional radiology-guided gastrostomy (IR-G), the need for withholding antiplatelet and anticoagulant medications, appropriate timing to initiate tube feedings, and appropriate selection of the gastrostomy technique in patients with malignant dysphagia. In patients needing enteral access, the ASGE suggests PEG as the preferred technique for initial gastrostomy over IR-G. The ASGE recommends that tube feeding can be safely started within 4 hours of the gastrostomy without the need for an intentional delay. The ASGE suggests that a PEG can be performed without the need to withhold antiplatelet medications. In patients on anticoagulants who need to undergo PEG placement, the ASGE suggests that the periprocedural management of anticoagulants should be based on a multidisciplinary discussion with the patient regarding the risk of bleeding versus cardiovascular adverse events. In patients with malignant dysphagia, either transoral "Pull" PEG or transcutaneous "Direct" PEG can be performed for initial enteral access.

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Publication Details

Journal
VideoGIE
Published
2024-11-28
DOI
https://doi.org/10.1016/j.vgie.2024.09.014
Citations
2
Primary Topic
Clinical Nutrition and Gastroenterology
Type
article
Field-Weighted Citation Impact
0.62

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article

American Society for Gastrointestinal Endoscopy guideline on gastrostomy feeding tubes: methodology and review of evidence

Bashar Qumseya, Nirav C Thosani, Nikhil Ravi Thiruvengadam, Amir Y. Kamel et al.
2 citations
VideoGIE
Clinical Nutrition and Gastroenterology
0.62
article

American Society for Gastrointestinal Endoscopy guideline on gastrostomy feeding tubes: methodology and review of evidence

Bashar Qumseya, Nirav C Thosani, Nikhil Ravi Thiruvengadam, Amir Y. Kamel, Rodrick C. Zvavanjanja, Saowanee Ngamruengphong, Nauzer Forbes, Sunil G. Sheth, Omeed Alipour, Dhruvil Radadiya, Stephen A. McClave, Neil B. Marya, Wenly Ruan, John C. Fang, Sherif Elhanafi, Wasif M. Abidi, Madhav Desai, Jorge D. Machicado, Natalie Danielle Cosgrove, Divyanshoo R. Kohli
article en
2 citations

Abstract

This article from the American Society for Gastrointestinal Endoscopy (ASGE) provides a full description of the methodology used to inform the final guidance outlined in the accompanying summary and recommendations article for strategies to manage endoscopically placed gastrostomy tubes. This article was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and specifically addresses the utility of PEG versus interventional radiology-guided gastrostomy (IR-G), the need for withholding antiplatelet and anticoagulant medications, appropriate timing to initiate tube feedings, and appropriate selection of the gastrostomy technique in patients with malignant dysphagia. In patients needing enteral access, the ASGE suggests PEG as the preferred technique for initial gastrostomy over IR-G. The ASGE recommends that tube feeding can be safely started within 4 hours of the gastrostomy without the need for an intentional delay. The ASGE suggests that a PEG can be performed without the need to withhold antiplatelet medications. In patients on anticoagulants who need to undergo PEG placement, the ASGE suggests that the periprocedural management of anticoagulants should be based on a multidisciplinary discussion with the patient regarding the risk of bleeding versus cardiovascular adverse events. In patients with malignant dysphagia, either transoral "Pull" PEG or transcutaneous "Direct" PEG can be performed for initial enteral access.

VideoGIEVol. 10(1)
Texas Tech University (US), Providence Sacred Heart Medical Center (US), Beth Israel Deaconess Medical Center (US), UF Health Shands Hospital (US), Harvard University (US), University of Louisville (US), Johns Hopkins University (US), University of Kansas (US), University of Massachusetts Chan Medical School (US), University of Calgary (CA), Washington State University Spokane (US), Baylor College of Medicine (US), University of Utah (US), Loma Linda University (US), AdventHealth Orlando (US), University of Washington Medical Center (US), The University of Kansas Health System (US), University of Florida (US), Michigan Medicine (US), University of Kansas Medical Center (US), Texas Children's Hospital (US), The University of Texas Health Science Center (US), UMass Memorial Medical Center (US), The University of Texas Health Science Center at Houston (US), Texas Tech University Health Sciences Center (US), Florida College (US)
American Society for Gastrointestinal Endoscopy
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Openalex Percentile: Top 32%
Clinical Nutrition and Gastroenterology
0.62
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