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Laparoscopic Witzel gastrostomy--a reappraised technique
1Department of Surgery, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung City, 807, Taiwan.
Surgical Endoscopy
|December 21, 2006
Summary
Laparoscopic Witzel gastrostomy (LWG) is a safe and effective method for long-term enteral feeding in head and neck cancer patients. This procedure offers a viable alternative to percutaneous endoscopic gastrostomy with minimal complications.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Head and Neck Surgery
Background:
- Laparoscopic gastrostomy is indicated for long-term enteral feeding when percutaneous endoscopic gastrostomy is not feasible.
- Head and neck cancer patients often require alternative feeding methods due to stenosis.
Purpose of the Study:
- To evaluate the feasibility, safety, and efficacy of laparoscopic Witzel gastrostomy (LWG).
- To assess complication rates, feeding support adequacy, and tolerability of LWG in head and neck cancer patients.
Main Methods:
- A series of 48 patients with stenotic head and neck or esophageal cancer underwent LWG.
- The procedure involved laparoscopic placement of a 16 F Foley catheter with a 4 cm seromuscular tunnel and gastropexy.
- Mean procedure duration was 62.4 minutes.
Main Results:
- LWG was successfully performed in all patients, with no conversions to open surgery or procedure-related mortality.
- A low complication rate of 11% was observed, consisting of minor issues like superficial wound infections.
- No major complications were reported, and the mean gastrostomy usage time was 6.3 months.
Conclusions:
- Laparoscopic Witzel gastrostomy is a safe, reproducible, and effective alternative for long-term enteral access.
- LWG demonstrates a favorable safety profile with a low incidence of complications compared to other methods.