Technical modifications for improving the success rate of PEG tube placement in patients with head and neck cancer

Background: Patients with head and neck cancer (HNC) benefit from nutritional support by means of PEG tubes, but endoscopy may be impossible when there is partial or complete trismus and/or stenosis or occlusion of the upper aerodigestive tract. Methods: PEG tubes were placed in 277 patients with HN...

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Bibliographic Details
Published in:	Gastrointestinal endoscopy Vol. 54; no. 5; pp. 633 - 636
Main Authors:	Taller, András, Horvath, Emília, Iliás, Lajos, Kótai, Zsuzsa, Simig, Mária, Élö, János, Harsányi, László
Format:	Journal Article
Language:	English
Published:	New York, NY Mosby, Inc 01-11-2001 Elsevier
Subjects:	Adult Aged Biological and medical sciences Deglutition Disorders - etiology Diseases of the digestive system Endoscopy, Digestive System - methods Enteral Nutrition - instrumentation Enteral Nutrition - methods Female Head and Neck Neoplasms - complications Humans Laryngoscopes Male Medical sciences Middle Aged Nasal Cavity Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Gastrostomy Human Stomach Improvement Carcinoma Follow up study Surgery Head and neck ENT disease Malignant tumor Technique Enteral administration
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Summary:	Background: Patients with head and neck cancer (HNC) benefit from nutritional support by means of PEG tubes, but endoscopy may be impossible when there is partial or complete trismus and/or stenosis or occlusion of the upper aerodigestive tract. Methods: PEG tubes were placed in 277 patients with HNC. Oral insertion of an endoscope into the esophagus was impossible in 27 patients. Transnasal endoscopy was performed (n = 4). In the cases of high-grade tumor obstruction, the endoscope was introduced into the esophagus through a straight laryngoscope (n = 9). When upper aerodigestive tract occlusion was present, endoscopy with PEG placement was successfully performed during surgery by means of the opened pharynx after tumor resection (n = 12). Results: In 25 of the 27 cases PEG tubes could be placed by using the above alternative techniques. There were no immediate complications, and no complications occurred within 30 days of PEG placement. Conclusions: Transnasal, straight laryngoscopic, or intraoperative open endoscopy can improve the success rate for PEG tube placement in patients with HNC.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0016-5107 1097-6779
DOI:	10.1067/mge.2001.119221