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Percutaneous endoscopic gastrostomy: strategies for prevention and management of complications.
Laryngoscope. 2001 Oct; 111(10):1847-52.L

Abstract

OBJECTIVE

The placement of percutaneous endoscopic gastrostomy (PEG) tubes is within the realm of the head and neck surgeon because most are proficient in the use of rigid and flexible esophagoscopes. The ability to provide comprehensive care for the patient with head and neck cancer provides further incentive for the head and neck surgeon to adopt this technique. Although it is a technically simple procedure, the surgeon must be aware of the range of complications that can occur with PEG. We review our experience with PEG focusing on the complications as well as strategies for the prevention and management of these complications.

METHODS

A retrospective review of the records of patients who underwent PEG at Stanford University by the Head and Neck Surgery Service between July 1992 and December 1998 was conducted. A total of 103 patients were identified, of which 84 (82%) were patients with head and neck cancers. Complications associated with PEG were identified. All PEGs were performed using the pull technique.

RESULTS

There was no mortality associated with the procedure. Minor complications occurred in 11 cases (10.7%). These included cellulitis (4), ileus (3), tube extrusion (1), clogged lumen (1), and peristomal leakage (2). The only major complication was a single case of PEG site metastasis.

CONCLUSION

The review of our experience with PEG tube placement revealed a low complication rate. Safe PEG placement was achieved by transillumination of the abdominal wall and confirmation by ballottement. In addition, appropriate patient selection, use of perioperative antibiotics, as well as meticulous post-procedure care contributed to the low rate of complications. For the patients with head and neck cancer, a barrier should be placed between the tumor and the instrumentation at the time of tube placement.

Authors+Show Affiliations

Division of Otolaryngology--Head and Neck Surgery, Stanford University Medical Center, Stanford, California 94305-5328, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11801956

Citation

Lin, H S., et al. "Percutaneous Endoscopic Gastrostomy: Strategies for Prevention and Management of Complications." The Laryngoscope, vol. 111, no. 10, 2001, pp. 1847-52.
Lin HS, Ibrahim HZ, Kheng JW, et al. Percutaneous endoscopic gastrostomy: strategies for prevention and management of complications. Laryngoscope. 2001;111(10):1847-52.
Lin, H. S., Ibrahim, H. Z., Kheng, J. W., Fee, W. E., & Terris, D. J. (2001). Percutaneous endoscopic gastrostomy: strategies for prevention and management of complications. The Laryngoscope, 111(10), 1847-52.
Lin HS, et al. Percutaneous Endoscopic Gastrostomy: Strategies for Prevention and Management of Complications. Laryngoscope. 2001;111(10):1847-52. PubMed PMID: 11801956.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous endoscopic gastrostomy: strategies for prevention and management of complications. AU - Lin,H S, AU - Ibrahim,H Z, AU - Kheng,J W, AU - Fee,W E, AU - Terris,D J, PY - 2002/1/22/pubmed PY - 2002/2/9/medline PY - 2002/1/22/entrez SP - 1847 EP - 52 JF - The Laryngoscope JO - Laryngoscope VL - 111 IS - 10 N2 - OBJECTIVE: The placement of percutaneous endoscopic gastrostomy (PEG) tubes is within the realm of the head and neck surgeon because most are proficient in the use of rigid and flexible esophagoscopes. The ability to provide comprehensive care for the patient with head and neck cancer provides further incentive for the head and neck surgeon to adopt this technique. Although it is a technically simple procedure, the surgeon must be aware of the range of complications that can occur with PEG. We review our experience with PEG focusing on the complications as well as strategies for the prevention and management of these complications. METHODS: A retrospective review of the records of patients who underwent PEG at Stanford University by the Head and Neck Surgery Service between July 1992 and December 1998 was conducted. A total of 103 patients were identified, of which 84 (82%) were patients with head and neck cancers. Complications associated with PEG were identified. All PEGs were performed using the pull technique. RESULTS: There was no mortality associated with the procedure. Minor complications occurred in 11 cases (10.7%). These included cellulitis (4), ileus (3), tube extrusion (1), clogged lumen (1), and peristomal leakage (2). The only major complication was a single case of PEG site metastasis. CONCLUSION: The review of our experience with PEG tube placement revealed a low complication rate. Safe PEG placement was achieved by transillumination of the abdominal wall and confirmation by ballottement. In addition, appropriate patient selection, use of perioperative antibiotics, as well as meticulous post-procedure care contributed to the low rate of complications. For the patients with head and neck cancer, a barrier should be placed between the tumor and the instrumentation at the time of tube placement. SN - 0023-852X UR - https://www.unboundmedicine.com/medline/citation/11801956/Percutaneous_endoscopic_gastrostomy:_strategies_for_prevention_and_management_of_complications_ L2 - https://doi.org/10.1097/00005537-200110000-00033 DB - PRIME DP - Unbound Medicine ER -