title: Endoclips for fixation of nasoenteral feeding tubes: a review.
abstract: BACKGROUND
  Maintaining the position of an endoscopically placed nasoenteral feeding tube beyond the pylorus is often problematic because of retrograde migration. Fixation of a feeding tube to the small intestinal wall with an endoclip may prevent this. This article reviews available literature on the feasibility, efficacy and safety of endoclips for fixation of nasoenteral feeding tubes.
  
  
  METHODS
  A systematic search of the English literature was performed using MEDLINE, EMBASE and Cochrane databases to identify articles assessing the use of endoclips for fixation of feeding tubes, as well as articles assessing duration of attachment of endoclips.
  
  
  RESULTS
  Five cohort series were identified that evaluated the applicability of endoclips for fixation of feeding tubes to the small intestinal wall. In all patients, except one, a nasoenteral feeding tube could be successfully fixated to the small intestinal wall. During follow-up, no spontaneous migrations of feeding tubes were observed. No complications related to placement or removal of endoclips were observed. Three comparative studies evaluated duration of attachment of different types of endoclips to the gastrointestinal wall. Duration of attachment ranged from less than 1 week to more than 18 weeks, depending on the type of endoclip.
  
  
  CONCLUSIONS
  Based on available literature the use of endoclips for fixation of nasoenteral feeding tubes is feasible, effective and safe. Data from randomized controlled trials are needed.
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands.
authors.forename: A M
authors.initials: AM
authors.lastname: Schrijver
authors.forename: P D
authors.initials: PD
authors.lastname: Siersema
authors.forename: F P
authors.initials: FP
authors.lastname: Vleggaar
authors.forename: M M C
authors.initials: MM
authors.lastname: Hirdes
authors.forename: J F
authors.initials: JF
authors.lastname: Monkelbaan
mesh_terms: D004750:Enteral Nutrition / Q000295:instrumentation*; D006801:Humans; D007421:Intestine, Small; D013525:Surgical Instruments; D013997:Time Factors