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Surgical Endoscopy

Published in:

01-10-2015

Peritonitis related to percutaneous endoscopic gastrostomy using the direct method for cancer patients

Authors: Shozo Osera, Tomonori Yano, Tomoyuki Odagaki, Yasuhiro Oono, Hiroaki Ikematsu, Atsushi Ohtsu, Kazuhiro Kaneko

Published in: Surgical Endoscopy | Issue 10/2015

Abstract

Background

Percutaneous endoscopic gastrostomy (PEG) using the direct method is generally indicated for cancer patients. However, there are little available data about peritonitis related to this method. The aim of this retrospective analysis was to assess peritonitis related to PEG using the direct method in patients with cancer.

Methods

We assessed the prevalence of peritonitis and the relationship between peritonitis and patients’ backgrounds, as well as the clinical course after peritonitis.

Results

Between December 2008 and December 2011, peritonitis was found in 9 (2.1 %) of 421 patients. Of the 9 patients with peritonitis, 4 had received PEG prior to chemoradiotherapy. Emergency surgical drainage was required in 1 patient, and the remaining 8 recovered with conservative treatment. Peritonitis occurred within 8 days of PEG for 8 of the 9 patients and occurred within 2 days of suture removal for 4 of the 9 patients.

Conclusion

Peritonitis related to PEG using the direct method was less frequent for cancer patients. Peritonitis tended to occur within a few days after removal of securing suture and in patients with palliative stage.

Gauderer MW, Ponsky JL, Izant RJ Jr (1980) Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg 15(6):872–875CrossRefPubMed

van Bokhorst-de van der Schueren MA, van Leeuwen PA, Sauerwein HP, Kuik DJ, Snow GB, Quak JJ (1997) Assessment of malnutrition parameters in head and neck cancer and their relation to postoperative complications. Head Neck 19(5):419–425CrossRefPubMed

Bassett MR, Dobie RA (1983) Patterns of nutritional deficiency in head and neck cancer. Otolaryngol Head Neck Surg 91(2):119–125PubMed

Beer KT, Krause KB, Zuercher T, Stanga Z (2005) Early percutaneous endoscopic gastrostomy insertion maintains nutritional state in patients with aerodigestive tract cancer. Nutr Cancer 52(1):29–34CrossRefPubMed

Locher JL, Bonner JA, Carroll WR, Caudell JJ, Keith JN, Kilgore ML, Ritchie CS, Roth DL, Tajeu GS, Allison JJ (2011) Prophylactic percutaneous endoscopic gastrostomy tube placement in treatment of head and neck cancer: a comprehensive review and call for evidence-based medicine. JPEN J Parenter Enteral Nutr 35(3):365–374CrossRefPubMed

Inoue N (2005) A new PEG technique “Direct Method” and fistula infection. Home Health Care Endosc Ther Qual Life 9:79–83

Foster JM, Filocamo P, Nava H, Schiff M, Hicks W, Rigual N, Smith J, Loree T, Gibbs JF (2007) The introducer technique is the optimal method for placing percutaneous endoscopic gastrostomy tubes in head and neck cancer patients. Surg Endosc 21(6):897–901CrossRefPubMed

Cruz I, Mamel JJ, Brady PG, Cass-Garcia M (2005) Incidence of abdominal wall metastasis complicating PEG tube placement in untreated head and neck cancer. Gastrointest Endosc 62(5):708–711 quiz 752, 753CrossRefPubMed

Hiki N, Maetani I, Suzuki Y, Washizawa N, Fukuda T, Yamaguchi T (2008) Reduced risk of peristomal infection of direct percutaneous endoscopic gastrostomy in cancer patients: comparison with the pull percutaneous endoscopic gastrostomy procedure. J Am Coll Surg 207(5):737–744CrossRefPubMed

10.

Horiuchi A, Nakayama Y, Tanaka N, Fujii H, Kajiyama M (2008) Prospective randomized trial comparing the direct method using a 24 Fr bumper-button-type device with the pull method for percutaneous endoscopic gastrostomy. Endoscopy 40(9):722–726CrossRefPubMed

11.

Yagishita A, Kakushima N, Tanaka M, Takizawa K, Yamaguchi Y, Matsubayashi H, Ono H (2012) Percutaneous endoscopic gastrostomy using the direct method for aerodigestive cancer patients. Eur J Gastroenterol Hepatol 24(1):77–81CrossRefPubMed

12.

Faias S, Buck G, Delegge M (2006) Peritonitis after percutaneous endoscopic gastrostomy and jejunostomy: where there is smoke, there may not be fire. Endoscopy 38(7):745–748CrossRefPubMed

13.

Richards DM, Tanikella R, Arora G, Guha S, Dekovich AA (2012) Percutaneous endoscopic gastrostomy in cancer patients: predictors of 30-day complications, 30-day mortality, and overall mortality. Dig Dis Sci 58:768–776CrossRefPubMed

14.

Richter-Schrag HJ, Richter S, Ruthmann O, Olschewski M, Hopt UT, Fischer A (2011) Risk factors and complications following percutaneous endoscopic gastrostomy: a case series of 1041 patients. Can J Gastroenterol 25(4):201–206PubMedCentralPubMed

Title: Peritonitis related to percutaneous endoscopic gastrostomy using the direct method for cancer patients
Authors: Shozo Osera
Tomonori Yano
Tomoyuki Odagaki
Yasuhiro Oono
Hiroaki Ikematsu
Atsushi Ohtsu
Kazuhiro Kaneko
Publication date: 01-10-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 10/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-4026-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Peritonitis related to percutaneous endoscopic gastrostomy using the direct method for cancer patients

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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