Direct percutaneous endoscopic gastrostomy for nutritional support in patients with aerodigestive tract cancers.

Autor: Yang LS; Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia., Taylor ACF; Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia., Thompson AJ; Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia., Desmond PV; Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia., Holt BA; Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.; Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: Internal medicine journal [Intern Med J] 2023 Jul; Vol. 53 (7), pp. 1218-1223. Date of Electronic Publication: 2022 Aug 27.
DOI: 10.1111/imj.15664
Abstrakt: Background: Conventional pull-through percutaneous endoscopic gastrostomy (PEG) risks infection and tumour implantation in head and neck cancers. Endoscopically inserted direct gastrostomy has lower rates of complications but is underutilised.
Aims: To describe the endoscopic steps for direct gastrostomy insertion and review our single-centre experience to assess the technical feasibility and safety.
Methods: Patients who underwent endoscopic direct gastrostomy insertion between December 2016 and June 2021 were included. A 24Fr introducer kit for gastrostomy feeding tube (Avanos Healthcare, Australia) was used. Patient and tumour characteristics, procedural data and 30-day outcomes were recorded.
Results: Thirty patients underwent direct PEG insertion (mean age 64 years and 24 male). All were planned for or currently undergoing radiotherapy. Twenty-six (87%) of 30 cases were performed under conscious sedation over a median procedure time of 21 min (interquartile range 11 min). No tumour seeding was seen, and one case of PEG-site infection was observed.
Conclusions: Direct PEG is safe and effective and should be considered for patients with aerodigestive tract cancer in need of nutritional support.
(© 2021 Royal Australasian College of Physicians.)
Databáze: MEDLINE
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