Pharyngocutaneous fistula as an alternative access route for inserting a percutaneous endoscopic gastrostomy tube in head and neck cancer patients

Autor: Louise Deluiz Verdolin Di Palma, Gustavo Francisco de Souza e Mello, Cindy Lis Granados, Ricardo Dardengo Glória, Caroline Sauter Dalbem, Rolantre Lopes da Cruz, Ana Carolina Maron Ayres, Renata Sofia Camara Lisboa, Alexandre Dias Pelosi, Maria Aparecida Ferreira, Gilberto Reynaldo Mansur, Simone Guaraldi da Silva, Theresa Christina Damian Ribeiro, Fernando Luiz Dias
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Endoscopy International Open, Vol 05, Iss 07, Pp E630-E634 (2017)
Druh dokumentu: article
ISSN: 2364-3722
2196-9736
DOI: 10.1055/s-0043-106581
Popis: Background and study aims Performing a percutaneous endoscopic gastrostomy (PEG) in head and neck cancer (HNC) patients can be challenging because of the presence of trismus, pharyngeal obstruction by tumor, and pharyngoesophageal strictures or fistula. Pharyngocutaneous fistula (PCF) is a major postoperative concern in patients submitted to total laryngectomy (TL). In the medical literature to date, the cervical fistula has been used as an access to PEG in only four reports. The aim of this study was to evaluate the safety of cervical fistula for insertion of a PEG tube. Patients and methods Retrospective study at a single tertiary referral center, regarding the technical feasibility, safety and outcomes of a PEG tube introduced by a cervical fistula in HNC patients with obstructive lesions of the oropharynx. Results The procedure was technically successful in all 21 patients. A PEG tube was used for a minimum of 1 month and a maximum of 120 months. Twelve patients died while using the PEG tube, 8 had it taken out because it was no longer needed, and only 1 had the tube still in use. Adverse events occurred in 8 patients: granuloma (19 %), dermatitis (9.5 %), accidental late removal of the tube (9.5 %), periprocedural gastric wall hematoma (9.5 %), peristomal wound infection (4.7 %), buried bumper syndrome (4.7 %), and traumatic gastric ulcer (4.7 %). Conclusion A postoperative cervical fistula can successfully work as a reliable and safe access for a PEG tube procedure in HNC patients, avoiding unnecessary surgery and reducing costs.
Databáze: Directory of Open Access Journals
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