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Timing of percutaneous endoscopic gastrostomy tube placement in head and neck cancer patients.
Otolaryngol Head Neck Surg. 1999 Apr; 120(4):479-82.OH

Abstract

Percutaneous endoscopic gastrostomy (PEG) is an effective method for providing alimentation in patients with upper aerodigestive tract carcinoma. Multiple complications of this procedure have been reported, ranging from leakage around the tube to tumor seeding of the abdominal cavity. This study was undertaken to determine whether the timing of PEG tube placement with respect to primary tumor extirpation led to a difference in the number and severity of observed complications. The medical records of 43 patients with head and neck carcinoma who had PEG tubes placed from 1995 to 1996 were retrospectively reviewed. Comparisons of timing of PEG tube placement, complication, location, and stage of the primary tumor were performed. In addition, the use of adjuvant therapy with respect to the time of PEG tube placement and complications was evaluated. Of these, 23% were done before and 30% during surgery at the time of primary tumor resection (9 of 13 were after primary removal). One patient had an intraabdominal abscess. Minor complications occurred in 15 of 43 patients (35%) and included granulation tissue at the PEG site, leakage, and tube displacement. Eight of the 9 patients who underwent intraoperative PEG after tumor resection had no complications. Patients who underwent PEG during or after surgery had significantly fewer complications than those who underwent preoperative PEG or had unresectable tumors (P = 0.038). The largest number of complications occurred in patients who underwent preoperative PEG (57%) followed by patients whose tumors were unresectable (31%). There was no statistical difference with regard to tumor location or postoperative x-ray therapy in PEG complications. This study demonstrates that PEG tube placement after tumor resection has the lowest incidence of postoperative complications. Performing PEGs intraoperatively after tumor resection can prevent the need for additional anesthesia to provide alimentation in patients with upper aerodigestive tract carcinoma.

Authors+Show Affiliations

Department of Surgery, Medical College of Georgia, Augusta 30912, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10187937

Citation

Raynor, E M., et al. "Timing of Percutaneous Endoscopic Gastrostomy Tube Placement in Head and Neck Cancer Patients." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 120, no. 4, 1999, pp. 479-82.
Raynor EM, Williams MF, Martindale RG, et al. Timing of percutaneous endoscopic gastrostomy tube placement in head and neck cancer patients. Otolaryngol Head Neck Surg. 1999;120(4):479-82.
Raynor, E. M., Williams, M. F., Martindale, R. G., & Porubsky, E. S. (1999). Timing of percutaneous endoscopic gastrostomy tube placement in head and neck cancer patients. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 120(4), 479-82.
Raynor EM, et al. Timing of Percutaneous Endoscopic Gastrostomy Tube Placement in Head and Neck Cancer Patients. Otolaryngol Head Neck Surg. 1999;120(4):479-82. PubMed PMID: 10187937.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Timing of percutaneous endoscopic gastrostomy tube placement in head and neck cancer patients. AU - Raynor,E M, AU - Williams,M F, AU - Martindale,R G, AU - Porubsky,E S, PY - 1999/4/3/pubmed PY - 1999/4/3/medline PY - 1999/4/3/entrez SP - 479 EP - 82 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 120 IS - 4 N2 - Percutaneous endoscopic gastrostomy (PEG) is an effective method for providing alimentation in patients with upper aerodigestive tract carcinoma. Multiple complications of this procedure have been reported, ranging from leakage around the tube to tumor seeding of the abdominal cavity. This study was undertaken to determine whether the timing of PEG tube placement with respect to primary tumor extirpation led to a difference in the number and severity of observed complications. The medical records of 43 patients with head and neck carcinoma who had PEG tubes placed from 1995 to 1996 were retrospectively reviewed. Comparisons of timing of PEG tube placement, complication, location, and stage of the primary tumor were performed. In addition, the use of adjuvant therapy with respect to the time of PEG tube placement and complications was evaluated. Of these, 23% were done before and 30% during surgery at the time of primary tumor resection (9 of 13 were after primary removal). One patient had an intraabdominal abscess. Minor complications occurred in 15 of 43 patients (35%) and included granulation tissue at the PEG site, leakage, and tube displacement. Eight of the 9 patients who underwent intraoperative PEG after tumor resection had no complications. Patients who underwent PEG during or after surgery had significantly fewer complications than those who underwent preoperative PEG or had unresectable tumors (P = 0.038). The largest number of complications occurred in patients who underwent preoperative PEG (57%) followed by patients whose tumors were unresectable (31%). There was no statistical difference with regard to tumor location or postoperative x-ray therapy in PEG complications. This study demonstrates that PEG tube placement after tumor resection has the lowest incidence of postoperative complications. Performing PEGs intraoperatively after tumor resection can prevent the need for additional anesthesia to provide alimentation in patients with upper aerodigestive tract carcinoma. SN - 0194-5998 UR - https://www.unboundmedicine.com/medline/citation/10187937/Timing_of_percutaneous_endoscopic_gastrostomy_tube_placement_in_head_and_neck_cancer_patients_ DB - PRIME DP - Unbound Medicine ER -