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Percutaneous endoscopic gastrostomy as a multidisciplinary treatment in head and neck cancer

Gastrostomía endoscópica percutánea como tratamiento multidisciplinario en cáncer de cabeza y cuello

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Abstract

The objective of this study was to evaluate the results of using the percutaneous endoscopic gastrostomy (PEG) in patients with head and neck cancer.

Forty-six patients with head or neck cancer who required a PEG were evaluated over a 3-year period. The main indications were dysphagia and as a palliative treatment. The early perioperative and short and long term complications were assessed as well as the morbidity and mortality rate related to the procedure.

In all cases, the PEG was successfully placed. Perioperative complications were observed in 6 (13%) cases, and the short and long term morbidity were seen in 4 (9%) cases. The side effects were considered as minor in all but 1 case, which required open surgery to remove the gastric tube because its bumper had become fully imbedded in the gastric wall after a 1-year period. No patient died from the procedure.

PEG is an easy, quick and safe technique for the short and long term nutrition in head and neck cancer patients, who need a combined treatment of chemotherapy, surgery and/or radiotherapy and in which complications related to any of these treatment were expected. PEG should be placed routinely if enteral feeding with a gastric tube is expected to be longer than 3 weeks.

Resumen

Evaluar los resultados del empleo de la gastrostomía endoscópica percutánea (GEP) en pacientes con cáncer de cabeza y cuello.

Evaluamos a 46 pacientes con cáncer de cabeza o cuello que requirieron GEP durante un período de 3 años. Las principales indicaciones fueron disfagia y como tratamiento paliativo. Valoramos las complicationes perioperatorias tempranas y las complicaciones a corto y a largo plazo, así como la morbilidad y la tasa de mortalidad relacionadas con el procedimiento.

En todos los casos la GEP se situó de modo satisfactorio. Observamos complicaciones perioperatorias en 6 (13%) casos y se observó morbilidad a corto y a largo plazo en 4 (9%) casos. Consideramos como menores los effectos secundarios en todos los casos menos en 1, que precisó cirugía abierta para retirar la sonda gástrica debido a que su tope se había incrustado completamente en la pared gástrica después de un período de 1 año. Ninguno de los pacientes falleció como consecuencia del procedimiento.

La GEP es una técnica fácil, rápida y segura para la nutrición a corto y largo plazo de los pacientes con cáncer de cabeza o cuello que necesitan un tratamiento combinado de quimioterapia y cirugía con o sin radioterapia y en los que se esperan complicacions relacionadas con cualquiera de estas modalidades de tratamiento. Se debe realizar las gastrostomía endoscópica percutánea de modo rutinario si se espera que la alimentación por vía entérica con una sonda gástrica vaya a superar las 3 semanas de duración.

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Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, Centre Hospitalier Universitaire Vauobis, Lausame, Switzerland

    Kuauhyama Luna-Ortiz, Philippe Monnier & Philippe Pasche

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  1. Kuauhyama Luna-Ortiz
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  2. Philippe Monnier
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  3. Philippe Pasche
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Correspondence to Kuauhyama Luna-Ortiz.

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Luna-Ortiz, K., Monnier, P. & Pasche, P. Percutaneous endoscopic gastrostomy as a multidisciplinary treatment in head and neck cancer. Rev Oncol 4, 22–27 (2002). https://doi.org/10.1007/BF02711635

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  • DOI: https://doi.org/10.1007/BF02711635

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