keyword
https://read.qxmd.com/read/36992552/availability-of-palliative-parenteral-nutrition-to-patients-with-advanced-cancer-a-national-survey-of-service-provision
#1
JOURNAL ARTICLE
James Baker, Philip J Smith, Simon J White, Alison J Gifford
BACKGROUND & AIMS: Patients with advanced malignancy who are unable to meet their nutritional requirements orally or enterally as a result of intestinal failure may be considered for parenteral nutrition support. Current United Kingdom (UK) guidance recommends that patients with 3-months prognosis and good performance status (i.e. Karnofsky performance status >50) should be considered for this intervention at home (termed Home Parenteral Nutrition; HPN). However, HPN is a nationally commissioned service by NHS England and Improvement which can only be initiated at specific National Health Service (NHS) centres so may not be easily accessed by patients outside of these centres...
March 29, 2023: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://read.qxmd.com/read/36729796/symptom-burden-in-patients-with-malignant-bowel-obstruction-treated-with-or-without-surgery
#2
JOURNAL ARTICLE
Reed I Ayabe, Tito Mendoza, Sriram Yennu, Eduardo Bruera, Loretta A Williams, Brian Badgwell
BACKGROUND: Gastrointestinal obstruction is the most common indication for palliative surgical consultation. We sought to assess patient-reported outcomes and survival after surgical and nonsurgical treatment of malignant bowel obstruction. STUDY DESIGN: This was a prospective observational study enrolling patients with advanced malignancy who underwent surgical consultation at a tertiary cancer center. Patient-reported outcomes were evaluated using a previously validated inventory, the MD Anderson Symptom Inventory-Gastrointestinal Obstruction (MDASI-GIO), administered at enrollment and 7 other time points for up to 90 days...
March 1, 2023: Journal of the American College of Surgeons
https://read.qxmd.com/read/36104161/venting-percutaneous-radiologic-gastrostomy-in-malignant-bowel-obstruction-safety-and-effectiveness-in-a-comprehensive-cancer-centre
#3
JOURNAL ARTICLE
Inmaculada Peiró, Jennifer Milla, Lorena Arribas, Laura Hurtós, Ana Regina González-Tampán, Marta Bellver, Eduard Fort, Kevin Molina-Mata, Jonathan R Joudanin, Joana Valcarcel, Jesús González-Barboteo
OBJECTIVE: Approximately 20% of established malignant bowel obstruction (MBO) patients do not respond to pharmacological treatment. In these cases, venting percutaneous radiologic gastrostomy (VPRG) may be useful. Existing evidence is based on retrospective studies with methodological limitations. The purpose of this study is to describe safety and effectiveness for symptom control after VPRG placement in a prospective cohort of MBO patients. METHODS: Complications of VPRG placement, symptom control, destination on discharge and survival were analysed...
September 14, 2022: BMJ Supportive & Palliative Care
https://read.qxmd.com/read/36014885/home-parenteral-nutrition-in-patients-with-advanced-cancer-quality-outcomes-from-a-centralized-model-of-care-delivery
#4
JOURNAL ARTICLE
Maja Kopczynska, Antje Teubner, Arun Abraham, Michael Taylor, Ashley Bond, Andrew Clamp, Rebecca Wight, Zena Salih, Jurjees Hasan, Claire Mitchell, Gordon C Jayson, Simon Lal
Lack of expertise in home parenteral nutrition (HPN) management has been reported as a barrier to its initiation in patients with advanced cancer (AC), and there are limited data describing hospital readmissions and HPN-related complications. We aimed to assess a centralized approach for managing HPN in AC and evaluate associated outcomes, including hospital readmissions and HPN-related complications. This was a cohort study of adults with AC requiring palliative HPN between 2010-2018 at a tertiary intestinal failure (IF) center, primarily utilizing a centralized model of HPN oversight to discharge patients remotely from an oncology center to their homes over a wide geographic area...
August 17, 2022: Nutrients
https://read.qxmd.com/read/35722598/endoscopically-placed-venting-gastrostomy-can-be-a-safe-and-effective-palliative-intervention-in-benign-and-malignant-gastrointestinal-obstruction
#5
JOURNAL ARTICLE
Ross J Porter, Alastair W McKinlay, Emma L Metcalfe
Introduction: Chronic gastrointestinal obstruction can precipitate a constellation of symptoms including nausea, vomiting, abdominal distension and pain that negatively impact on health-related quality of life. Decompression via venting gastrostomy can offer symptomatic relief but safety and efficacy data are sparse. This study characterises the diverse venting percutaneous endoscopic gastrostomy (vPEG) cohort at our tertiary referral centre and defines the safety and efficacy of this procedure...
2022: Frontline Gastroenterology
https://read.qxmd.com/read/35479596/use-of-a-large-diameter-30-french-venting-gastrostomy-tube-is-effective-and-safe-for-symptom-palliation-in-patients-with-malignant-bowel-obstruction
#6
JOURNAL ARTICLE
M Phillip Fejleh, Michael Chang, Gobind Anand, Thomas J Savides
Background: Treatment options for malignant bowel obstruction are limited, particularly in poor surgical candidates. Standard percutaneous endoscopic gastrostomy (PEG) tubes used for venting are of small caliber, limiting success. This study examines outcomes in patients who received larger-caliber 30-Fr PEGs for treatment of malignant bowel obstruction. Method: Retrospective chart review for all patients who received a large-caliber venting PEGs for malignant bowel obstruction in a series of patients at a single institution...
March 2022: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://read.qxmd.com/read/35123817/the-role-of-surgery-in-the-palliation-of-advanced-pelvic-malignancy
#7
JOURNAL ARTICLE
Kah Hoong Chang, Michael J Solomon
Advanced pelvic malignancy, regardless of the cancer of origin, is often multivisceral and complex. The management of advanced pelvic malignancy is resource-intensive and requires multidisciplinary input. The definition of resectability is evolving with improving multimodal therapy, preoperative staging and optimisation, perioperative care, and advanced surgical techniques. Pelvic exenteration is a highly morbid procedure and has been shown to improve survival and quality of life when performed with a curative intent...
January 21, 2022: European Journal of Surgical Oncology
https://read.qxmd.com/read/34435974/gastropericardial-fistula-after-unconventional-venting-gastrostomy-placement-in-encapsulating-peritoneal-sclerosis
#8
JOURNAL ARTICLE
Daniela Guerrero Vinsard, Patrice Vinsard
No abstract text is available yet for this article.
January 1, 2022: American Journal of Gastroenterology
https://read.qxmd.com/read/34313239/assessment-of-complication-rates-based-on-time-of-feeding-initiation-in-radiologically-guided-gastrostomy-tubes-a-retrospective-study
#9
JOURNAL ARTICLE
Ryan Judd, Wesley Klejch, Alexander Lionberg, Mikin V Patel, Brian Funaki, Osman Ahmed
PURPOSE: We aimed to assess the association between complication rate and time to feeding in a cohort of patients undergoing radiologically guided placement of gastrostomy tubes. METHODS: A retrospective study was conducted of all patients receiving pull-type and push-type gastrostomy tubes placed by interventional radiologists between January 1st, 2017 and December 31st, 2018 at a single institution. Primary outcomes included procedural and tube-related complications per medical chart review with a follow-up interval of 30 days...
July 2021: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://read.qxmd.com/read/34125305/management-of-intractable-symptoms-in-oncologic-care
#10
REVIEW
Katie L Dziedzic, Ross H Albert
PURPOSE OF REVIEW: For patients undergoing evaluation and treatment of cancers, symptom management is a critical component of their treatment plan. For some patients, symptoms may become intractable or refractory to common therapies. Here, we review treatment options for these severe symptom conditions. RECENT FINDINGS: Medication options and regimens have improved to treat refractory symptoms. Medications can be tailored to treat chemotherapy-induced nausea and vomiting based on current guidelines...
June 14, 2021: Current Oncology Reports
https://read.qxmd.com/read/33907622/venting-issues
#11
JOURNAL ARTICLE
Neel Sharma, Rachel Cooney, Sheldon C Cooper
UNLABELLED: Introduction: A 65-year-old woman with type 3 intestinal failure secondary to scleroderma of the gut (limited cutaneous sclerosis (centromere positive) and rheumatoid arthritis (anti-cyclic citrullinated peptide (CCP) and rheumatoid factor positive)) on home parenteral nutrition since 2011 underwent a venting PEG replacement in 2015 for intractable vomiting due to gut dysmotility and small bowel bacterial overgrowth, poorly responding to cyclical antibiotics. An endoscopy was undertaken for planned PEG review for consideration of elective replacement (figure 1)...
2021: Frontline Gastroenterology
https://read.qxmd.com/read/33813072/aga-clinical-practice-update-on-the-optimal-management-of-the-malignant-alimentary-tract-obstruction-expert-review
#12
REVIEW
Osman Ahmed, Jeffrey H Lee, Christopher C Thompson, Ashley Faulx
BACKGROUND & AIMS: The purpose of this expert review is to describe the current methodologies available to manage malignant alimentary tract obstructions as well the evidence behind the various methods (including their efficacy and safety), indications, and appropriate timing of interventions. METHODS: This is not a formal systematic review but is based on a review of the literature to provide best practice advice statements. No formal rating of the quality of evidence or strength of recommendation is carried out...
September 2021: Clinical Gastroenterology and Hepatology
https://read.qxmd.com/read/33549000/a-retrospective-review-of-the-use-of-oxymorphone-immediate-release-for-long-term-pain-control-in-cancer-patients-with-gastrostomy-tubes
#13
JOURNAL ARTICLE
Akhila Reddy, Marieberta Vidal, Ali Haider, Joseph Arthur, David Hui, Jimin Wu, Diane Liu, Carolyn Holmes, Michelle Carrol, Shalini Dalal, Rony Dev, Kimberson Tanco, Eduardo Bruera
BACKGROUND: Cancer patients often require feeding or venting gastrostomy-tubes (G-tubes) for enteral nutrition or symptom palliation. The administration of most extended-release (ER) opioids via the G-tube or orally followed by clamping of the venting G-tube is contraindicated. Oxymorphone immediate release (IR) may be useful because of its longer half-life compared to other IR opioids. We examined the use of oxymorphone IR administered every 8 hours in patients with G-tubes. METHODS: This was a retrospective chart review of 40 consecutive cancer patients with G-tubes who underwent opioid rotation (OR) to oxymorphone...
March 2021: Annals of Palliative Medicine
https://read.qxmd.com/read/32684298/techniques-and-devices-for-the-endoscopic-treatment-of-gastroparesis-with-video
#14
JOURNAL ARTICLE
Mansour A Parsi, Pichamol Jirapinyo, Barham K Abu Dayyeh, Manoop S Bhutani, Vinay Chandrasekhara, Kumar Krishnan, Nikhil A Kumta, Joshua Melson, Rahul Pannala, Guru Trikudanathan, Arvind J Trindade, Amrita Sethi, Rabindra R Watson, John T Maple, David R Lichtenstein
BACKGROUND AND AIMS: Gastroparesis is a symptomatic chronic disorder of the stomach characterized by delayed gastric emptying in the absence of mechanical obstruction. Several endoscopic treatment modalities have been described that aim to improve gastric emptying and/or symptoms associated with gastroparesis refractory to dietary and pharmacologic management. METHODS: In this report we review devices and techniques for endoscopic treatment of gastroparesis, the evidence regarding their efficacy and safety, and the financial considerations for their use...
September 2020: Gastrointestinal Endoscopy
https://read.qxmd.com/read/32026525/dealing-with-loss-food-and-eating-in-women-with-ovarian-cancer-on-parenteral-nutrition
#15
JOURNAL ARTICLE
A M Sowerbutts, S Lal, J Sremanakova, A R Clamp, G C Jayson, L Hardy, E Sutton, A-M Raftery, A Teubner, S Burden
BACKGROUND: Malignant bowel obstruction is a common complication of ovarian cancer, resulting in limited oral intake. Home parenteral nutrition (HPN) may be offered to patients in this condition to meet nutritional requirements. However, it is not known how they experience being unable to eat. The present study reports how patients related to food when receiving HPN. METHODS: The investigation was a qualitative study underpinned by phenomenology with women with advanced ovarian cancer in bowel obstruction receiving parenteral nutrition...
February 6, 2020: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://read.qxmd.com/read/31597626/percutaneous-venting-gastrostomy-gastrojejunostomy-for-malignant-bowel-obstruction-a-qualitative-study
#16
JOURNAL ARTICLE
Rebecca Singh Curry, Elizabeth Evans, Anne-Marie Raftery, Julia Hiscock, Marlise Poolman
OBJECTIVE: Malignant bowel obstruction (MBO) is a complication of advanced malignancy and is associated with a short prognosis. MBO can infrequently be reversed by surgery or stenting. The focus of treatment is usually symptomatic management, of which percutaneous venting gastrostomy/gastrojejunostomy (PVG) is one consideration. There is little data considering the impact of PVG on quality of life; we therefore aimed to explore this. METHODS: We identified patients with a PVG inserted for MBO and those who consented to participate were interviewed...
December 2019: BMJ Supportive & Palliative Care
https://read.qxmd.com/read/31485901/pancreatic-head-resection-following-roux-en-y-gastric-bypass-operative-considerations-and-outcomes
#17
JOURNAL ARTICLE
M T Trudeau, L Maggino, B L Ecker, C M Vollmer
PURPOSE: This study aimed to identify optimal management decisions for surgeons preforming pancreatic head resection on patients with altered anatomy due to a previous Roux-en-Y gastric bypass (RYGB). METHODS: A multi-national (4), multi-center (28) collaborative of 55 pancreatic surgeons who have performed pancreatoduodenectomy or total pancreatectomy following RYGB for obesity (2005-2018) was created. Demographics, operative details, and perioperative outcomes from this cohort were analyzed and compared in a propensity-score matched analysis with a multi-center cohort of 5533 pancreatoduodenectomies without prior RYGB...
January 2020: Journal of Gastrointestinal Surgery
https://read.qxmd.com/read/31448682/safety-and-efficacy-of-venting-gastrostomy-in-malignant-bowel-obstruction-a-systematic-review
#18
JOURNAL ARTICLE
Sreeharshan Thampy, Pavan Najran, Damian Mullan, Hans-Ulrich Laasch
Malignant bowel obstruction (MBO) is a common manifestation in patients with advanced intra-abdominal malignancy. It is especially common with bowel or gynecological cancers and produces distressing symptoms, including nausea, vomiting, and pain. Medical management options are less effective than decompressive strategies for symptom control. Surgery is the gold-standard treatment but is unsuitable for most patients with high complication rates. Consensus guidelines recommend nonsurgical management with a venting gastrostomy in those unsuitable for surgery or for whom medical management is ineffective...
April 2020: Journal of Palliative Care
https://read.qxmd.com/read/31314176/practical-management-approach-to-gastroparesis
#19
REVIEW
Kieran J Longley, Vincent Ho
Gastroparesis is a syndrome characterised by delayed gastric emptying in the absence of mechanical obstruction. Symptoms can include early satiety, abdominal pain, bloating, vomiting and regurgitation which cause significant morbidity in addition to nutritional deficits. There is a higher prevalence in diabetics and females, but the incidence in the Australian population has not been well studied. Management of gastroparesis involves investigating and correcting nutritional deficits, optimising glycaemic control and improving gastrointestinal motility...
August 2020: Internal Medicine Journal
https://read.qxmd.com/read/31248897/return-of-the-old-guard-a-case-of-tetanus-in-an-unvaccinated-patient
#20
JOURNAL ARTICLE
Uzochukwu Ibe, Sameerah Rehmani, Nasheena Jiwa, Arjet Gega
A 78-year-old woman with no known medical history presented with severe neck pain that began 4 days prior to admission located in the paraspinal cervical region radiating to the shoulders, legs and back. She had associated stiffness of her neck and progression of pain to her jaw and throat with progression to generalised body spasms with lower extremity stiffness and weakness that limited her ability to walk. She quickly developed dysphagia and odynophagia with subsequent generalised spasms and profound hypoxic respiratory failure requiring nasotracheal intubation...
June 26, 2019: BMJ Case Reports
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