A new large-caliber trocar for percutaneous endoscopic gastrostomy by the introducer technique in head and neck cancer patients

Carregando...
Imagem de Miniatura
Citações na Scopus
11
Tipo de produção
article
Data de publicação
2011
Título da Revista
ISSN da Revista
Título do Volume
Editora
GEORG THIEME VERLAG KG
Citação
ENDOSCOPY, v.43, n.9, p.752-758, 2011
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background and study aims In many patients, percutaneous endoscopic gastrostomy (PEG) can be limited by digestive tract stenosis. PEG placement using an introducer is the safest alternative for this group of patients, but the available devices are difficult to implement and require smaller-caliber tubes. The aim of this study was to evaluate the modification of an introducer technique device for PEG placement with regard to the following: procedure feasibility, possibility of using a 20-Fr balloon gastrostomy tube, tube-related function and problems, complications, procedure safety, and mortality. Patients and methods Between March 2007 and February 2008, 30 consecutive patients with head and neck malignancies underwent introducer PEG placement with the modified device and gastropexy. Each patient was evaluated for 60 days after the procedure for the success of the procedure, infection, pain, complications, mortality, and problems with the procedure. Results The procedure was successful in all cases with no perioperative complications. No signs of stomal infection were observed using the combined infection score. The majority of patients experienced mild-to-moderate pain both in the immediate postoperative period and at 72 hours. One major early complication (3.3%) and two minor complications (6.7%) were observed. No procedure-related deaths occurred during the first 60 days after the procedure. Conclusion The device modification for PEG using the introducer technique is feasible, safe, and efficient in outpatients with obstructive head and neck cancer. In this series, it allowed the use of a larger-caliber tube with low complication rates and no procedure-related mortality.
Palavras-chave
Referências
  1. Adler DG, 2001, GASTROINTEST ENDOSC, V54, P237, DOI 10.1016/S0016-5107(01)70117-4
  2. Taller A, 2001, GASTROINTEST ENDOSC, V54, P633, DOI 10.1067/mge.2001.119221
  3. Cruz I, 2005, GASTROINTEST ENDOSC, V62, P708, DOI 10.1016/j.gie.2005.06.041
  4. JAIN NK, 1987, ANN INTERN MED, V107, P824
  5. Foster JM, 2007, SURG ENDOSC, V21, P897, DOI 10.1007/s00464-006-9068-9
  6. Simon T, 2000, SURG ENDOSC-ULTRAS, V14, P436, DOI 10.1007/s004640000163
  7. Blum CA, 2009, AM SURGEON, V75, P39
  8. Potochny JD, 1998, SURG ENDOSC-ULTRAS, V12, P1361, DOI 10.1007/s004649900858
  9. Ehrsson YT, 2004, CLIN OTOLARYNGOL, V29, P740, DOI 10.1111/j.1365-2273.2004.00897.x
  10. Wiesen AJ, 2006, GASTROINTEST ENDOSC, V64, P886, DOI 10.1016/j.gie.2006.06.088
  11. Grant DG, 2009, CLIN OTOLARYNGOL, V34, P103, DOI 10.1111/j.1749-4486.2009.01889.x
  12. Lin HS, 2001, LARYNGOSCOPE, V111, P1847, DOI 10.1097/00005537-200110000-00033
  13. Nicholson FB, 2000, J GASTROEN HEPATOL, V15, P21, DOI 10.1046/j.1440-1746.2000.02004.x
  14. HUNTER JG, 1989, ANN SURG, V210, P42, DOI 10.1097/00000658-198907000-00006
  15. GAUDERER MWL, 1980, J PEDIATR SURG, V15, P872, DOI 10.1016/S0022-3468(80)80296-X
  16. RUSSELL TR, 1984, AM J SURG, V148, P132, DOI 10.1016/0002-9610(84)90300-3
  17. Horiuchi A, 2008, ENDOSCOPY, V40, P722, DOI 10.1055/s-2008-1077490
  18. Terry NE, 2008, SURG ENDOSC, V22, P167, DOI 10.1007/s00464-007-9402-x
  19. Shastri YM, 2008, GASTROINTEST ENDOSC, V67, P620, DOI 10.1016/j.gie.2007.10.044
  20. Loser C, 1998, DIGEST DIS SCI, V43, P2549, DOI 10.1023/A:1026615106348
  21. Baredes Soly, 2004, Ear Nose Throat J, V83, P417
  22. Bhama JK, 2001, SURG LAPARO ENDO PER, V11, P375, DOI 10.1097/00019509-200112000-00008
  23. CAMPOLI PMO, 2007, ABCD ARQUIVOS BRASIL, V20, P97
  24. Cappell MS, 2007, AM J GASTROENTEROL, V102, P1307, DOI 10.1111/j.1572-0241.2007.01227.x
  25. Cosentini EP, 1998, ARCH SURG-CHICAGO, V133, P1076, DOI 10.1001/archsurg.133.10.1076
  26. Dormann AJ, 2006, AM J GASTROENTEROL, V101, P1229, DOI 10.1111/j.1572-0241.2006.00541.x
  27. Dormann AJ, 2000, Z GASTROENTEROL, V38, P933, DOI 10.1055/s-2000-10025
  28. GIBSON SE, 1992, ANN OTO RHINOL LARYN, V101, P46
  29. GIORDANONAPPI JH, 2007, ENDOSCOPY S1, V39, P274
  30. KOZAREK RA, 1986, AM J GASTROENTEROL, V81, P642
  31. MILLER R E, 1989, Surgical Endoscopy, V3, P186, DOI 10.1007/BF02171543
  32. MILLER RE, 1986, ANN SURG, V204, P543, DOI 10.1097/00000658-198611000-00006
  33. Petersen TI, 1997, EUR J SURG, V163, P351
  34. Pisano Giuseppe, 2008, Chir Ital, V60, P261
  35. Pofahl WE, 1999, SURG LAPARO ENDO PER, V9, P253, DOI 10.1097/00019509-199908000-00004
  36. RILEY DA, 1992, ANN OTO RHINOL LARYN, V101, P310
  37. Sabnis A, 2006, SURG ENDOSC, V20, P256, DOI 10.1007/s00464-005-0383-3
  38. Schneider AM, 1997, AM SURGEON, V63, P481
  39. SOBREIRA RS, 2006, GED, V25, P37
  40. Stockeld D, 2001, EUR J SURG, V167, P839
  41. Toyama Y, 2007, SURG ENDOSC, V21, P2034, DOI 10.1007/s00464-007-9270-4
  42. Tsai John K, 2007, Gastrointest Endosc Clin N Am, V17, P777, DOI 10.1016/j.giec.2007.07.012
  43. Tucker AT, 2003, LARYNGOSCOPE, V113, P1898, DOI 10.1097/00005537-200311000-00007
  44. WOJTOWYCZ MM, 1988, AM J ROENTGENOL, V151, P307