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Endoscopy 2011; 43(9): 752-758
DOI: 10.1055/s-0030-1256495
Original article

© Georg Thieme Verlag KG Stuttgart · New York

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

J.  H.  Giordano-Nappi1 , F.  Maluf-Filho1 , S.  Ishioka1 , F.  Y.  Hondo1 , S.  E.  Matuguma1 , M.  Simas de Lima1 , M.  Lera dos Santos1 , F.  A.  Retes1 , P.  Sakai1
  • 1Department of Gastroenterology, Hospital das Clínicas, Medical School of São Paulo University, São Paulo, Brazil
Weitere Informationen

Publikationsverlauf

submitted 19 August 2010

accepted after revision 6 March 2011

Publikationsdatum:
07. Juni 2011 (online)

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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.

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J. H. Giordano-NappiMD, PhD 

Department of Gastroenterology
Gastrointestinal Endoscopy Unit
Hospital das Clínicas
Medical School of São Paulo University

Av. Dr Eneas Carvalho de Aguiar 255
6 ° Andar, Bloco C
São Paulo
Brazil

Fax: 55-11-30697579

eMail: drgiordano@hotmail.com