Background and study aims
In many patients, percutaneous endoscopic gastrostomy (PEG) can be limited by digestive
tract stenosis. PEG placement using an introducer is the safest alternative for this
group of patients, but the available devices are difficult to implement and require
smaller-caliber tubes. The aim of this study was to evaluate the modification of an
introducer technique device for PEG placement with regard to the following: procedure
feasibility, possibility of using a 20-Fr balloon gastrostomy tube, tube-related function
and problems, complications, procedure safety, and mortality.
Patients and methods
Between March 2007 and February 2008, 30 consecutive patients with head and neck malignancies
underwent introducer PEG placement with the modified device and gastropexy. Each patient
was evaluated for 60 days after the procedure for the success of the procedure, infection,
pain, complications, mortality, and problems with the procedure.
Results
The procedure was successful in all cases with no perioperative complications. No
signs of stomal infection were observed using the combined infection score. The majority
of patients experienced mild-to-moderate pain both in the immediate postoperative
period and at 72 hours. One major early complication (3.3 %) and two minor complications
(6.7 %) were observed. No procedure-related deaths occurred during the first 60 days
after the procedure.
Conclusion
The device modification for PEG using the introducer technique is feasible, safe,
and efficient in outpatients with obstructive head and neck cancer. In this series,
it allowed the use of a larger-caliber tube with low complication rates and no procedure-related
mortality.
References
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