Abstract
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.
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References
- Enteral nutrition: accessing patients.Nutrition. 1992; 8: 223-229
- Percutaneous endoscopy-controlled gastrostomy.Z Gastroenterol. 1989; 27 ([German]): 65-68
- Gastrostomy without laparotomy: a percutaneous endoscopic technique.J Pediatr Surg. 1980; 15: 872-875
- Percutaneous endoscopic gastrostomy: an update.Endoscopy. 1998; 30: 781-789
- Percutaneous endoscopically guided gastrostomy in patients with head and neck cancer.Rec Res Canc Res. 1991; 121: 269-282
- Transmaxillary percutaneous endoscopic gastrostomy.Gastrointest Endosc. 1994; 40: 778-779
- A nonoperative technique for establishment of a gastrostomy in the dog.Invest Radiol. 1983; 18: 485-487
- Percutaneous gastrostomy. A new simplified and cost-effective technique.Am J Surg. 1984; 148: 132-137
- Complications of percutaneous endoscopic gastrostomy in the head and neck cancer patients.Ann Otol Rhinol Laryngol. 1992; 10l: 46-50
- Percutaneous endoscopic gastrostomy in head and neck cancer patients.Ann Surg. 1989; 210: 42-46
- Percutaneous endoscopic gastrostomy in patients with head and neck malignancies.Am J Surg. 1991; 162: 381-383
- Percutaneous endoscopic gastrostomy in the cancer patient.Am Surg. 1988; 54: 419-422
- Percutaneous endoscopic gastrostomy. Indications, success, complications and mortality in 314 consecutive patients.Gastroenterology. 1987; 93: 48-52
- Transnasal endoscopic technique for feeding tube placement.Gastrointest Endosc. 1992; 38: 596-597
- Unsedated trans-nasal pharyngoesophagogastroduodenoscopy (T-EGD): technique.Gastrointest Endosc. 1994; 40: 346-348
- Prospective comparison of nasal versus oral insertion of a thin video endoscope in healthy volunteers.Endoscopy. 1996; 28: 422-424
- A comparison of transnasal and transoral endoscopy with small-diameter endoscopes in unsedated patients.Gastrointest Endosc. 1999; 49: 292-296
- The nose: is this the route to improving esophagogastroduodenoscopy?.Gastrointest Endosc. 1999; 49 ([editorial]): 395-398
- Head and neck cancer implantation at the percutaneous endoscopic gastrostomy exit site. A case report and a review.Surg Endosc. 1998; 12: 1361-1365
- Tumour seeding following percutaneous endoscopic gastrostomy in head and neck cancer.Postgrad Med J. 1997; 73: 430-432
Article info
Publication history
Accepted:
August 3,
2001
Received in revised form:
October 30,
2000
Received:
September 11,
2000
Footnotes
☆Reprint requests: András Taller, MD, Department of Gastroenterology, Uzsoki Teaching Hospital, Uzsoki utca 29. H-1145, Budapest, Hungary.
Identification
Copyright
© 2001 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
