Menni A, Tzikos G, Chatziantoniou G, Gionga P, Papavramidis TS, Shrewsbury A, Stavrou G, Kotzampassi K. Buried bumper syndrome: A critical analysis of endoscopic release techniques. World J Gastrointest Endosc 2023; 15(2): 44-55 [PMID: 36925650 DOI: 10.4253/wjge.v15.i2.44]
Corresponding Author of This Article
Katerina Kotzampassi, Doctor, MD, PhD, Senior Scientist, Surgeon, Department of Surgery, Aristotle University of Thessaloniki, University Campus, Thessaloniki 54636, Greece. kakothe@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Feb 16, 2023; 15(2): 44-55 Published online Feb 16, 2023. doi: 10.4253/wjge.v15.i2.44
Buried bumper syndrome: A critical analysis of endoscopic release techniques
Alexandra Menni, Georgios Tzikos, George Chatziantoniou, Persefoni Gionga, Theodosios S Papavramidis, Anne Shrewsbury, George Stavrou, Katerina Kotzampassi
Alexandra Menni, Georgios Tzikos, George Chatziantoniou, Persefoni Gionga, Theodosios S Papavramidis, Anne Shrewsbury, George Stavrou, Katerina Kotzampassi, Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
Author contributions: Menni A, Giogga P, Georgios C, and Papavramidis T performed the literature review and drafted the manuscript; Tzikos G and Stavrou G performed a critical revision; Shrewsbury A performed language editing, drafted and critically revised the manuscript; Kotzampassi K conceived the original idea, performed the literature review, drafted and critically revised the manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The informed consent was waived from the patients.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Katerina Kotzampassi, Doctor, MD, PhD, Senior Scientist, Surgeon, Department of Surgery, Aristotle University of Thessaloniki, University Campus, Thessaloniki 54636, Greece. kakothe@yahoo.com
Received: November 16, 2022 Peer-review started: November 16, 2022 First decision: December 11, 2022 Revised: December 23, 2022 Accepted: January 23, 2023 Article in press: January 23, 2023 Published online: February 16, 2023
Abstract
Buried bumper syndrome (BBS) is the situation in which the internal bumper of the gastrostomy tube, due to prolonged compression of the tissues between the external and the internal bumper, migrates from the gastric lumen into the gastric wall or further, into the tract outside the gastric lumen, ending up anywhere between the stomach mucosa and the surface of the skin. This restricts liquid food from entering the stomach, since the internal opening is obstructed by gastric mucosal overgrowth. We performed a comprehensive search of the PubMed literature to retrieve all the case-reports and case-series referring to BBS and its management, after which we focused on the endoscopic techniques for releasing the internal bumper to re-establish the functionality of the tube. From the “push” and the “push and pull T” techniques to the most sophisticated-using high tech instruments, all 10 published techniques have been critically analysed and the pros and cons presented, in an effort to optimize the criteria of choice based on maximum efficacy and safety.
Core Tip: Buried bumper syndrome is the situation in which the internal bumper of the gastrostomy tube migrates from the gastric lumen into the gastric wall and thus its internal opening is obstructed by gastric mucosal overgrowth. We performed an analysis of the endoscopic techniques described in the literature for releasing the internal bumper to re-establish the functionality of the tube, in an effort to optimize the criteria of choice based on maximum efficacy and safety.
