Percutaneous gastrostomy: the Stanford experience

Many techniques have been devised to provide enteral nutrition to the patient with cancer of the head and neck. No single technique will be adequate for all patients, but our experience with percutaneous gastrostomy has encouraged us to recommend it as a valuable alternative to conventional modalities. The charts of 156 patients, identified by computer-assisted search as having undergone gastrostomy at Stanford University Hospital or Palo Alto Veterans Administration Hospital from 1984 to 1987, were reviewed. Of these, 24 patients with a primary diagnosis of head and neck malignancy underwent percutaneous gastrostomy and form the basis for this study. Parameters evaluated included operation time, type of anesthesia, perioperative complications, and cost. Percutaneous gastrostomy can be performed under local anesthesia or at the time of routine head and neck procedures such as staging endoscopy. Our success with this technique leads us to recommend it as a valuable alternative for providing nutrition to head and neck cancer patients.