Sa1628 Safety and Efficacy of Overtubes for Preventing Cutaneous Metastasis During PEG Tube Placement in Patients With Head and Neck Cancer: a Single-Center Study

2014 ◽  
Vol 79 (5) ◽  
pp. AB280
Author(s):  
Crispin O. Musumba ◽  
Chiao-Yun (Julia) Hsu ◽  
Golo Ahlenstiel ◽  
Nicholas J. Tutticci ◽  
Kavinderjit S. Nanda ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cutaneous Metastasis ◽  
Tube Placement ◽  
Single Center ◽  
Safety And Efficacy ◽  
Single Center Study ◽  
Peg Tube ◽  
Center Study

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

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Crispin O. Musumba ◽  
Julia Hsu ◽  
Golo Ahlenstiel ◽  
Nicholas J. Tutticci ◽  
Kavinderjit S. Nanda ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cutaneous Metastasis ◽  
Tube Placement ◽  
Endoscopic Gastrostomy ◽  
Peristomal Infection ◽  
Westmead Hospital ◽  
Safe Technique ◽  
Peg Tube

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.

Technical modifications for improving the success rate of PEG tube placement in patients with head and neck cancer

2001 ◽  
Vol 54 (5) ◽  
pp. 633-636 ◽  
Author(s):  
András Taller ◽  
Emília Horvath ◽  
Lajos Iliás ◽  
Zsuzsa Kótai ◽  
Mária Simig ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Success Rate ◽  
Neck Cancer ◽  
Tube Placement ◽  
Technical Modifications ◽  
Peg Tube

Prophylactic Versus Reactive Gastrostomy Tubes in Head and Neck Cancer: Making Joint Decisions

2019 ◽  
Vol 4 (6) ◽  
pp. 1525-1530
Author(s):  
Daniel J. Croake ◽  
Vrushali Angadi
Keyword(s):  
Decision Making ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Relevant Literature ◽  
Tube Placement ◽  
Patient Factors ◽  
Percutaneous Gastrostomy ◽  
Swallowing Problems ◽  
Peg Tube

Purpose Patients undergoing chemoradiation for treatment of head and neck cancer often develop swallowing problems that necessitate a percutaneous gastrostomy (PEG) tube. Studies comparing various outcomes related to timing of PEG tubes placed either prophylactically or reactively do not show a clear advantage to either method; however, pertinent patient factors may help determine an educated and evidence-based decision. Additionally, patients may not be included in decision making regarding PEG placement and may not receive adequate education regarding PEG tubes, resulting in fears and concerns. Thus, patients may wish to avoid or at least delay PEG tube placement until necessary. The purpose of this viewpoint article is to review relevant literature and describe patient concerns to better facilitate joint decision making of PEG tube timing with the patient and care team. Conclusion Patient counseling and inclusion can be useful in helping patients understand why and when a PEG tube may be beneficial or necessary during treatment. A simplified decision tree is introduced that incorporates several relevant patient factors based on the current literature and can be used jointly by clinicians and patients to reach a mutual decision by incorporating clinical factors while being mindful of patient values.

Survey of the experience of head and neck cancer patients with a percutaneous endoscopic gastrostomy tube.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18501-e18501
Author(s):  
Kamal Kant Sahu ◽  
Lisa Gibbs ◽  
Ahmad Daniyal Siddiqui
Keyword(s):  
Head And Neck Cancer ◽  
Cancer Treatment ◽  
Head And Neck ◽  
Neck Cancer ◽  
Tube Placement ◽  
Cancer Site ◽  
Free Text ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Medical Reason ◽  
Peg Tube

e18501 Background: Many patients with advanced head and neck cancer become unable to obtain enough nutrition and hydration orally, leading to considerable weight loss and compromised clinical outcomes. PEG tube is ideal for this population who require longer term nutrition support because of cancer treatment. The study objective was to learn about the experience of patients with a PEG tube. Methods: A questionnaire was developed, tested, and used to collect data. This survey consisted of 20 questions pertinent to various domains of quality of life and aiming at various aspects of patient life: physical, emotional and social sectors and noting their experiences in the form of multiple-choice options using Likert scale and free text option for suggestions. Results: A total of 22 participants were involved in this study, 64 years,7 males and 5 females. Cancer site: Tongue (10), tonsils (5), pharynx (5) and larynx (2). All patients belonged to stage III or more. Majority were treated with chemoradiotherapy (17 ). Out of 22 patients, 18 had PEG tube placement before starting treatment and the other 4 agreed during the cancer treatment. Most patients had the PEG tube for 3-6 months (8/22 cases). 21 patients strongly agree that PEG tube insertion was useful to them for their treatment and nutrition. 21 patients agreed relying on PEG tube FOR > 75% of their daily nutrition. While 4 patients agreed that PEG hampered their ADLs, 13 patients suggested that only rarely (7 cases) or sometimes (6 cases) they encountered difficulty in managing their ADLs. Only 2 patients had often trouble with sleep.15 cases did not feel any social embarrassment with PEG and did not miss any social events.19 patients answered that they followed oncologists to have PEG tube placement. Majority (15) managed the tube feed on their own. 16 cases never had any clinic/ER visit solely due to PET tube issues. 20 patients considered dietician as the first person to connect for concerns. 8 patients experienced issues like tube site infection (5), leakage (5), bleeding from site (4), tube blockade (5) or tube replacement (2). All patients except one agreed to have PEG placement again in future if required for any medical reason and would recommend others as well. Similarly, all patients except one thought that they would not have completed the cancer treatment without PEG tube support. Conclusions: Results indicate that the patient experience with the PEG tube is generally positive. This study will help improve understanding regarding the experience of living with a PEG tube from the patient perspective.

scholarly journals Metastatic Implantation of Head and Neck Squamous Cell Cancer at PEG Tube Site Exit— An Unusual Relapse Site: A Case Report and Review of Literature

2011 ◽  
Vol 2 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Vijay Palwe ◽  
Kaustav Talpatra ◽  
Umesh Mahantshetty ◽  
Seethalaxmi Viswanathan
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Gastrostomy Tube ◽  
Tube Placement ◽  
Endoscopic Gastrostomy ◽  
Gastrostomy Tube Placement ◽  
Peg Tube

ABSTRACT Background The placement of percutaneous endoscopic gastrostomy (PEG) tubes is a common procedure in patients with head and neck cancer who require adequate nutrition because of the inability to swallow before or after surgery and adjuvant therapies. A potential complication of percutaneous endoscopic gastrostomy tubes is the metastatic spread from the original head and neck tumor to the gastrostomy site. Methods This is a case of a 55-year-old male with a (cT4N3M0) stage IV squamous cell carcinoma of the oropharynx who underwent percutaneous endoscopic gastrostomy tube placement prior to commencement of definitive chemoradiation therapy and 7 months thereafter developed metastatic spread to the gastrostomy site. Tumor was treated with radiation therapy. A review of the published literature regarding the subject is done. The pull-through method of gastrostomy tube placement had been used in our patient as well as in the majority of the other cases reviewed in the literature. Conclusions There is a small but definite risk for tumor implantation in the gastrostomy site when using the pull technique in patients with active head and neck cancer. The direct implantation of tumor through instrumentation is the most likely explanation for metastasis; however, hematogenous seeding is also a possibility. Careful assessment of the oropharynx and hypopharynx before PEG tube placement and the use of alternative techniques for enteral access in patients with untreated or residual malignancy are recommended to minimize this risk.

Prophylactic versus Reactive PEG Tube Placement in Head and Neck Cancer

2013 ◽  
Vol 150 (3) ◽  
pp. 407-412 ◽  
Author(s):  
Scott Kramer ◽  
Matthew Newcomb ◽  
Joshua Hessler ◽  
Farzan Siddiqui
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Tube Placement ◽  
Peg Tube
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