Percutaneous endoscopic gastrostomy tube replacement after head and neck surgery: A case report.
| Autor: | Attia AC; UPMC Harrisburg, 205 S Front St, Harrisburg, PA 17104, United States of America. Electronic address: aattia29@gmail.com., Childers WK; UPMC Harrisburg, Department of General Surgery, 205 S Front St, Harrisburg, PA 17104, United States of America. Electronic address: childerswk@upmc.edu. |
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| Jazyk: | angličtina |
| Zdroj: | International journal of surgery case reports [Int J Surg Case Rep] 2022 Jul; Vol. 96, pp. 107323. Date of Electronic Publication: 2022 Jun 18. |
| DOI: | 10.1016/j.ijscr.2022.107323 |
| Abstrakt: | Introduction: Percutaneous endoscopic gastrostomy (PEG) has been available since the 1980s. Routine replacement is conducted at bedside with relatively few complications. Two replacement methods have come into practice: the percutaneous method and the endoscopic method. The laparoscopic method has recently become favorable in the pediatric population. Presentation of Case: Herein, we describe a situation in which a gastrostomy tube was replaced at bedside on a patient with previous head and neck surgery for lingual cancer. The percutaneous traction method was used, and gastrostomy tube replacement into the gastric lumen could not be confirmed on subsequent imaging. The patient was ultimately taken to surgery for an open procedure where it was discovered that initial PEG placement had traversed the small bowel mesentery en route to the gastric lumen. Discussion: The PEG tube is not a permanent device and routine exchange every 6-12 months is recommended. The percutaneous method and endoscopic method for gastrostomy tube replacement have both been used routinely, each with their set of complications. A third technique, laparoscopic placement, is the preferred modality in the pediatric population. Advantages are twofold: direct visualization of the stomach, thus eliminating inadvertent hollow viscus injury, and applicability in infants too small to undergo endoscopy necessary for PEG tube placement. Conclusion: Consideration for laparoscopic placement or replacement in the head and neck cancer patient population, in which interval endoscopy is impossible, is thus advocated. (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| Databáze: | MEDLINE |
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