Complications of Fluoroscopically Guided Percutaneous Gastrostomy With Large-bore Balloon-retained Catheter in Patients With Head and Neck Tumors

To review the complications, mortality rate and nutritional status of patients with head and neck cancer after fluoroscopically guided percutaneous gastrostomy (FPG). Methods: We retrospectively recruited 110 patients who had undergone FPG using 14-French balloon-retained catheters. The mortality ra...

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Bibliographic Details
Main Authors: Siu-Cheung Chan, Chiu-Wing Winnie Chu, Chun-Ta Liao, Kar-Wai Lui, Sheung-Fat Ko, Shu-Hang Ng
Format: Article
Language:English
Published: Elsevier 2010-08-01
Series:Journal of the Formosan Medical Association
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Online Access:http://www.sciencedirect.com/science/article/pii/S0929664610600988
Description
Summary:To review the complications, mortality rate and nutritional status of patients with head and neck cancer after fluoroscopically guided percutaneous gastrostomy (FPG). Methods: We retrospectively recruited 110 patients who had undergone FPG using 14-French balloon-retained catheters. The mortality rate, procedural and catheter-related complications, and Eastern Cooperative Oncology Group performance status were reviewed. Peritonitis, abscess, septicemia and bleeding were defined as major complications. Tube-related problems, including dislodgment, obstruction, leakage, vomiting and infection, were classified as minor complications. Results: Patients were stratified according to Eastern Cooperative Oncology Group performance status as follows: grade 0 (n=6); grade 1 (n=22); grade 2 (n=44); grade 3 (n=29); and grade 4 (n=7). The respective complication rates were 21%, 24%, 26%, and 29% for grades 1–4; however, there were no significant intergrade differences. The rates of major and minor complications were 1.9% and 20.0%, respectively. A total of 47 (43.5%) patients succumbed due to cancer deterioration; however, there was no gastrostomy-induced mortality. The catheter-occlusion rate of 3.7% in this cohort was significantly lower than that reported in other pigtail-retained gastrostomy studies. Conclusion: FPG is a safe method with low mortality and complication rate for constructing long-term enteral access in patients with head and neck cancer and esophageal abnormalities, who have no endoscopic access to the stomach.
ISSN:0929-6646