Prospective experience of percutaneous endoscopic gastrostomy tubes placed by otorhinolaryngologist-head and neck surgeons : safe and efficacious

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Ruohoalho , J , Aro , K , Makitie , A A , Atula , T , Haapaniemi , A , Keski-Santti , H , Kylanpaa , L , Takala , A & Back , L J 2017 , ' Prospective experience of percutaneous endoscopic gastrostomy tubes placed by otorhinolaryngologist-head and neck surgeons : safe and efficacious ' , European Archives of Oto-Rhino-Laryngology , vol. 274 , no. 11 , pp. 3971-3976 . https://doi.org/10.1007/s00405-017-4732-3

Title: Prospective experience of percutaneous endoscopic gastrostomy tubes placed by otorhinolaryngologist-head and neck surgeons : safe and efficacious
Author: Ruohoalho, Johanna; Aro, Katri; Makitie, Antti A.; Atula, Timo; Haapaniemi, Aaro; Keski-Santti, Harri; Kylanpaa, Leena; Takala, Annika; Back, Leif J.
Contributor organization: Korva-, nenä- ja kurkkutautien klinikka
Clinicum
University of Helsinki
Department of Ophthalmology and Otorhinolaryngology
Department of Surgery
II kirurgian klinikka
Anestesiologian yksikkö
Department of Diagnostics and Therapeutics
HUS Head and Neck Center
HUS Perioperative, Intensive Care and Pain Medicine
Date: 2017-11
Language: eng
Number of pages: 6
Belongs to series: European Archives of Oto-Rhino-Laryngology
ISSN: 0937-4477
DOI: https://doi.org/10.1007/s00405-017-4732-3
URI: http://hdl.handle.net/10138/298077
Abstract: Percutaneous endoscopic gastrostomy (PEG) is often the treatment of choice in head and neck cancer (HNC) patients needing long-term nutritional support. Prospective studies on PEG tube placement in an otorhinolaryngologist service are lacking. At our hospital, otolaryngologist-head and neck (ORL-HN) surgeons-have performed PEG insertions for HNC patients since 2008. We prospectively analyzed 127 consecutive HNC patients who received their PEG tubes at the Department of Otorhinolaryngology-head and neck surgery, and evaluated the outcome of PEG tube insertions performed by ORL-HN surgeons. To compare time delays before and after, PEG placement service was transferred from gastrointestinal surgeons to ORL-HN surgeons, and we retrospectively analyzed a separate group of 110 HNC patients who had earlier received PEG tubes at the Department of Gastrointestinal Surgery. ORL-HN surgeons' success rate in PEG insertion was 97.6%, leading to a final prospective study group of 124 patients. Major complications occurred in four (3.2%): two buried bumper syndromes, one subcutaneous hemorrhage leading to an abscess in the abdominal wall, and one metastasis at the PEG site. The most common minor complication was peristomal granulomatous tissue affecting 23 (18.5%) patients. After the change in practice, median time delay before PEG insertion decreased from 13 to 10 days (P <0.005). The proportion of early PEG placements within 0-3 days increased from 3.6 to 14.6% (P <0.005). PEG tube insertion seems to be a safe procedure in the hands of an ORL-HN surgeon. Independence from gastrointestinal surgeons' services reduced the time delay and improved the availability of urgent PEG insertions.
Subject: PEG
Head and neck cancer
Complications
Nutrition
Enteral feeding
ABDOMINAL-WALL METASTASIS
OF-THE-LITERATURE
CANCER-PATIENTS
RISK-FACTORS
COMPLICATIONS
INSERTION
MORTALITY
CARCINOMA
SITE
3125 Otorhinolaryngology, ophthalmology
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion


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