Complications of percutaneous endoscopic gastrostomy tube insertion in cancer patients: a retrospective study

Dysphagia, with associated malnutrition is a common feature in up to 64 % of patients with cancers of the head and neck region, the oesophagus and the gastro-oesophageal junction (Donaldson and Lenon Cancer 43(Suppl 5):2036-52, 1979). These patients usually require alternate routes of feeding during treatment. However, these methods of feeding are not without associated complications. This study was carried out to assess the complications associated with percutaneous endoscopic gastrostomy tube insertion, the commonest means of providing nutrition in this patient group.

Two hundred and sixty patients with successful percutaneous endoscopic gastrostomy (PEG) tube insertion were retrospectively reviewed to assess the complications of the procedure.

The overall complication rate was 25 % (65 patients). Fifty-five patients (21 %) patients had minor complications. Ten patients (3.8 %) suffered a major complication, including peritonitis and major peri-PEG infection each in three patients (1.2 %), while oesophageal perforation, collection around the PEG insertion site requiring operative drainage, bleeding from the PEG insertion site and tumour seeding at the gastrostomy site were each seen in one (0.4 %) patient.

Percutaneous endoscopic gastrostomy tube insertion is a useful means of providing enteral nutrition to patients with swallowing problems. Patients with head and neck cancer who are likely to develop dysphagia should be assessed promptly for PEG tube insertion before the start of radiation. Early recognition and prompt treatment of serious complications can avoid potential fatality associated with PEG tubes.