Feasibility and Safety of Overtubes for PEG-Tube Placement in Patients with Head and Neck Cancer

Background. Percutaneous endoscopic gastrostomy (PEG) placement using the “pull” technique is commonly utilized for providing nutritional support in head and neck cancer (HNC) patients, but it may be complicated by peristomal metastasis in up to 3% of patients. Overtube-assisted PEG placement might...

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Main Authors:	Musumba, Crispin O., Hsu, Julia, Ahlenstiel, Golo, Tutticci, Nicholas J., Nanda, Kavinderjit S., van der Poorten, David, Lee, Eric Y., Kwan, Vu
Format:	Online
Language:	English
Published:	Hindawi Publishing Corporation 2015
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419231/

id	pubmed-4419231
recordtype	oai_dc
spelling	pubmed-44192312015-05-14 Feasibility and Safety of Overtubes for PEG-Tube Placement in Patients with Head and Neck Cancer Musumba, Crispin O. Hsu, Julia Ahlenstiel, Golo Tutticci, Nicholas J. Nanda, Kavinderjit S. van der Poorten, David Lee, Eric Y. Kwan, Vu Research Article Background. Percutaneous endoscopic gastrostomy (PEG) placement using the “pull” technique is commonly utilized for providing nutritional support in head and neck cancer (HNC) patients, but it may be complicated by peristomal metastasis in up to 3% of patients. Overtube-assisted PEG placement might reduce this risk. However, this technique has not been systemically studied for this purpose to date. Methods. Retrospective analysis of consecutive patients with HNC who underwent overtube-assisted PEG placement at Westmead Hospital, Australia, between June 2011 and December 2013. Data were extracted from patients' endoscopy reports and case notes. We present our technique for PEG insertion and discuss the feasibility and safety of this method. Results. In all 53 patients studied, the PEG tubes were successfully placed using 25 cm long flexible overtubes, in 89% prophylactically (before commencing curative chemoradiotherapy), and in 11% reactively (for treatment of tumor related dysphagia or weight loss). During a median follow-up period of 16 months, 3 (5.7%) patients developed peristomal infection and 3 others developed self-limiting peristomal pain. There were no cases of overtube-related adverse events or overt cutaneous metastases observed. Conclusions. Overtube-assisted PEG placement in patients with HNC is a feasible, simple, and safe technique and might be effective for preventing cutaneous metastasis. Hindawi Publishing Corporation 2015 2015-04-21 /pmc/articles/PMC4419231/ /pubmed/25977688 http://dx.doi.org/10.1155/2015/612610 Text en Copyright © 2015 Crispin O. Musumba et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Musumba, Crispin O. Hsu, Julia Ahlenstiel, Golo Tutticci, Nicholas J. Nanda, Kavinderjit S. van der Poorten, David Lee, Eric Y. Kwan, Vu
spellingShingle	Musumba, Crispin O. Hsu, Julia Ahlenstiel, Golo Tutticci, Nicholas J. Nanda, Kavinderjit S. van der Poorten, David Lee, Eric Y. Kwan, Vu Feasibility and Safety of Overtubes for PEG-Tube Placement in Patients with Head and Neck Cancer
author_facet	Musumba, Crispin O. Hsu, Julia Ahlenstiel, Golo Tutticci, Nicholas J. Nanda, Kavinderjit S. van der Poorten, David Lee, Eric Y. Kwan, Vu
author_sort	Musumba, Crispin O.
title	Feasibility and Safety of Overtubes for PEG-Tube Placement in Patients with Head and Neck Cancer
title_short	Feasibility and Safety of Overtubes for PEG-Tube Placement in Patients with Head and Neck Cancer
title_full	Feasibility and Safety of Overtubes for PEG-Tube Placement in Patients with Head and Neck Cancer
title_fullStr	Feasibility and Safety of Overtubes for PEG-Tube Placement in Patients with Head and Neck Cancer
title_full_unstemmed	Feasibility and Safety of Overtubes for PEG-Tube Placement in Patients with Head and Neck Cancer
title_sort	feasibility and safety of overtubes for peg-tube placement in patients with head and neck cancer
description	Background. Percutaneous endoscopic gastrostomy (PEG) placement using the “pull” technique is commonly utilized for providing nutritional support in head and neck cancer (HNC) patients, but it may be complicated by peristomal metastasis in up to 3% of patients. Overtube-assisted PEG placement might reduce this risk. However, this technique has not been systemically studied for this purpose to date. Methods. Retrospective analysis of consecutive patients with HNC who underwent overtube-assisted PEG placement at Westmead Hospital, Australia, between June 2011 and December 2013. Data were extracted from patients' endoscopy reports and case notes. We present our technique for PEG insertion and discuss the feasibility and safety of this method. Results. In all 53 patients studied, the PEG tubes were successfully placed using 25 cm long flexible overtubes, in 89% prophylactically (before commencing curative chemoradiotherapy), and in 11% reactively (for treatment of tumor related dysphagia or weight loss). During a median follow-up period of 16 months, 3 (5.7%) patients developed peristomal infection and 3 others developed self-limiting peristomal pain. There were no cases of overtube-related adverse events or overt cutaneous metastases observed. Conclusions. Overtube-assisted PEG placement in patients with HNC is a feasible, simple, and safe technique and might be effective for preventing cutaneous metastasis.
publisher	Hindawi Publishing Corporation
publishDate	2015
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419231/
_version_	1613218961561747456

Feasibility and Safety of Overtubes for PEG-Tube Placement in Patients with Head and Neck Cancer

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