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Published on: December 27, 2024
Direct percutaneous endoscopic gastrostomy for nutritional support in patients with aerodigestive tract cancers
Linda S Yang1,2, Andrew C F Taylor1,2, Alexander J Thompson1,2
1Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
Background:
Conventional pull-through percutaneous endoscopic gastrostomy (PEG) risks infection and tumour implantation in head and neck cancers. Endoscopically inserted direct gastrostomy has lower rates of complications but is underutilised.
Aims:
To describe the endoscopic steps for direct gastrostomy insertion and review our single-centre experience to assess the technical feasibility and safety.
Methods:
Patients who underwent endoscopic direct gastrostomy insertion between December 2016 and June 2021 were included. A 24Fr introducer kit for gastrostomy feeding tube (Avanos Healthcare, Australia) was used. Patient and tumour characteristics, procedural data and 30-day outcomes were recorded.
Results:
Thirty patients underwent direct PEG insertion (mean age 64 years and 24 male). All were planned for or currently undergoing radiotherapy. Twenty-six (87%) of 30 cases were performed under conscious sedation over a median procedure time of 21 min (interquartile range 11 min). No tumour seeding was seen, and one case of PEG-site infection was observed.
Conclusions:
Direct PEG is safe and effective and should be considered for patients with aerodigestive tract cancer in need of nutritional support.
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