Percutaneous Transesophageal Access for Enteral Feeding Tube Placement

Background The purpose of this study was to describe our experience with percutaneous transesophageal enteral feeding tube placement when percutaneous gastrostomy tube placement is not feasible. Materials and Methods A retrospective review was performed from July 2018 to March 2019. Thirteen patients (9 females, 4 males), (age range 22-80 years; mean age, 55 years; mean body mass index of 24.6) underwent placement of 14 percutaneous transesophageal enteral feeding tubes. Relative contraindications to standard gastrostomy tube placement included: prior gastric surgery (5 patients), severe contractures/large body habitus (2), abdominal mesh (1), high riding stomach (1), interposition of bowel (1), ascites (1), and refractory gastrostomy tract leak (1). Patients were evaluated for functionality of the tube, complications, and patients' satisfaction with physical examination at 24 h, review of electronic medical record and phone interviews at 1 month, and 3-month follow-up. Complications were classified according to the CIRSE guidelines. Results Technical success rate was 100% with placement of seven percutaneous transesophageal gastrostomy tubes and seven percutaneous transesophageal jejunostomy tubes. One patient underwent tube placement twice after dislodgement. At 3-month follow-up, two patients had died, one patient was lost to follow-up, and 11 patients had properly working tubes. No major complications occurred. Minor complication rate was 43% (6/14). Patient's satisfaction scores ranged from poor 2/11 (18%) or neutral 4/11 (36.4%) to satisfied/very satisfied 5/11 (45.3%). Conclusion Percutaneous transesophageal enteral feeding tube placement is feasible with a low complication rate. A majority of patients were either satisfied or neutral with the transesophageal enteral tube.