Safety of pull-type and introducer percutaneous endoscopic gastrostomy tubes in oncology XXXX : a retrospective analysis.

@entity1 @entity326 @entity5 @entity2737 @entity970
BACKGROUND: Percutaneous endoscopic gastrostomy ( @entity970 ) allows long-term tube feeding. Safety of pull-type and introducer @entity970 placement in oncology @entity1 with head/neck or oesophageal @entity5 is unknown. METHODS: Retrospective analysis of 299 @entity1 undergoing @entity970 tube placement between January 2006 and December 2008 revealed 57 oncology @entity1 . All @entity1 with head/neck or oesophageal malignancy were treated with chemo- and radiotherapy. In case of high-grade stenosis introducer Freka   Pexact @entity970 tube was placed (n = 24) and in all other @entity1 (n = 33) conventional pull-type @entity970 tube. Short-term complications and mortality rates were compared. RESULTS: @entity1 ' characteristics and clinical status were comparable in both groups. Short-term complications were encountered in 11/24 (48%) introducer @entity970 @entity1 as compared to only 4/33 (12%) pull-type @entity970 @entity1 (P < 0.05). Accidental removal of the introducer @entity970 tube occurred in 4/24 (17%) with need for surgical intervention in 1 vs. 0/33 (0%, P < 0.05). @entity2737 occurred in 3/24 (12%) leading to @entity326 and admission to intensive care unit (ICU) in 1 vs. 3/33 (9%, NS). Finally, 3/24 gastrointestinal perforations (12%) resulted from a difficult placement procedure vs. 1/33 (3%), leading to urgent surgical intervention and admission to ICU. Two introducer @entity970 @entity1 died at ICU, resulting in an overall mortality rate of 8% vs. 0% (P = 0.091). CONCLUSION: The introducer Freka   Pexact @entity970 procedure for long-term tube feeding may lead to significantly higher complication and mortality rates in @entity1 with head/neck or oesophageal @entity5 treated with chemo- and radiotherapy. It is suggested to use the conventional pull-type @entity970 tube placement in this group of @entity1 , if possible.
