Gastrostomy insertion in head and neck cancer patients

A 3 year review of insertion method and complication rates

P. McAllister, C. Maciver, C. Wales, J. McMahon, J. C. Devine, G. McHattie, B. Makubate

Research output: Contribution to journalReview article

16 Citations (Scopus)

Abstract

Patients with head and neck cancer who have resection, radiotherapy, chemoradiotherapy, or a combination of these require nutritional support to be implemented before treatment, and this may involve insertion of a prophylactic gastrostomy feeding tube. The aim of this study was to compare the use and complication rates of percutaneous endoscopic gastrostomy (PEG) and radiologically inserted gastrostomy (RIG) in these patients at a tertiary referral centre. We retrospectively reviewed gastrostomy data forms completed by nutritional support nursing staff over a recent 34-month period, which included information on method of insertion, 30-day postoperative serious and minor complications, and mortality. A total of 110 patients had prophylactic insertion of a gastrostomy (21 PEG, 89 RIG) over the study period. In the first 12 months 13 (31%) PEG feeding tubes were placed but in the last 12 months none were inserted using an endoscopic approach. Serious complications occurred with 2 (10%) PEG and 12 (13%) RIG; the most common cause was accidental removal of the tube (n = 13, 12%). Minor complications of peristomal infection, leakage, or blockage of the tube occurred in 6 (5%) gastrostomies. No patients died during the study period. In recent years, and in the absence of recommended guidelines, there has been an increase in the elective insertion of RIG in patients with head and neck cancer. Serious complications for both methods of insertion in this study are comparable with similar reports. However, with RIG there is a high rate of tubes becoming dislodged with the potential for serious consequences. The most appropriate method to insert a gastrostomy tube in patients with head and neck cancer remains unclear.

Original languageEnglish
Pages (from-to)714-718
Number of pages5
JournalBritish Journal of Oral and Maxillofacial Surgery
Volume51
Issue number8
DOIs
Publication statusPublished - Dec 1 2013

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Gastrostomy
Head and Neck Neoplasms
Nutritional Support
Enteral Nutrition
Nursing Staff
Chemoradiotherapy
Tertiary Care Centers

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology

Cite this

McAllister, P. ; Maciver, C. ; Wales, C. ; McMahon, J. ; Devine, J. C. ; McHattie, G. ; Makubate, B. / Gastrostomy insertion in head and neck cancer patients : A 3 year review of insertion method and complication rates. In: British Journal of Oral and Maxillofacial Surgery. 2013 ; Vol. 51, No. 8. pp. 714-718.
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abstract = "Patients with head and neck cancer who have resection, radiotherapy, chemoradiotherapy, or a combination of these require nutritional support to be implemented before treatment, and this may involve insertion of a prophylactic gastrostomy feeding tube. The aim of this study was to compare the use and complication rates of percutaneous endoscopic gastrostomy (PEG) and radiologically inserted gastrostomy (RIG) in these patients at a tertiary referral centre. We retrospectively reviewed gastrostomy data forms completed by nutritional support nursing staff over a recent 34-month period, which included information on method of insertion, 30-day postoperative serious and minor complications, and mortality. A total of 110 patients had prophylactic insertion of a gastrostomy (21 PEG, 89 RIG) over the study period. In the first 12 months 13 (31{\%}) PEG feeding tubes were placed but in the last 12 months none were inserted using an endoscopic approach. Serious complications occurred with 2 (10{\%}) PEG and 12 (13{\%}) RIG; the most common cause was accidental removal of the tube (n = 13, 12{\%}). Minor complications of peristomal infection, leakage, or blockage of the tube occurred in 6 (5{\%}) gastrostomies. No patients died during the study period. In recent years, and in the absence of recommended guidelines, there has been an increase in the elective insertion of RIG in patients with head and neck cancer. Serious complications for both methods of insertion in this study are comparable with similar reports. However, with RIG there is a high rate of tubes becoming dislodged with the potential for serious consequences. The most appropriate method to insert a gastrostomy tube in patients with head and neck cancer remains unclear.",
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Gastrostomy insertion in head and neck cancer patients : A 3 year review of insertion method and complication rates. / McAllister, P.; Maciver, C.; Wales, C.; McMahon, J.; Devine, J. C.; McHattie, G.; Makubate, B.

In: British Journal of Oral and Maxillofacial Surgery, Vol. 51, No. 8, 01.12.2013, p. 714-718.

Research output: Contribution to journalReview article

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T2 - A 3 year review of insertion method and complication rates

AU - McAllister, P.

AU - Maciver, C.

AU - Wales, C.

AU - McMahon, J.

AU - Devine, J. C.

AU - McHattie, G.

AU - Makubate, B.

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N2 - Patients with head and neck cancer who have resection, radiotherapy, chemoradiotherapy, or a combination of these require nutritional support to be implemented before treatment, and this may involve insertion of a prophylactic gastrostomy feeding tube. The aim of this study was to compare the use and complication rates of percutaneous endoscopic gastrostomy (PEG) and radiologically inserted gastrostomy (RIG) in these patients at a tertiary referral centre. We retrospectively reviewed gastrostomy data forms completed by nutritional support nursing staff over a recent 34-month period, which included information on method of insertion, 30-day postoperative serious and minor complications, and mortality. A total of 110 patients had prophylactic insertion of a gastrostomy (21 PEG, 89 RIG) over the study period. In the first 12 months 13 (31%) PEG feeding tubes were placed but in the last 12 months none were inserted using an endoscopic approach. Serious complications occurred with 2 (10%) PEG and 12 (13%) RIG; the most common cause was accidental removal of the tube (n = 13, 12%). Minor complications of peristomal infection, leakage, or blockage of the tube occurred in 6 (5%) gastrostomies. No patients died during the study period. In recent years, and in the absence of recommended guidelines, there has been an increase in the elective insertion of RIG in patients with head and neck cancer. Serious complications for both methods of insertion in this study are comparable with similar reports. However, with RIG there is a high rate of tubes becoming dislodged with the potential for serious consequences. The most appropriate method to insert a gastrostomy tube in patients with head and neck cancer remains unclear.

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