Percutaneous transesophageal gastrostomy in gynecologic oncology patients with symptomatic malignant bowel...

Malignant bowel obstruction (MBO) is a frequent complication in patients with advanced gynecologic malignancies. Percutaneous transesophageal gastrostomy tubes (PTEG) were developed as an alternative in patients when percutaneous endoscopic gastrostomy (PEG) is technically difficult or clinically contraindicated.

Here we present three cases of women with gynecologic cancers with MBO who failed conservative or medical management and had a PTEG placed for palliative gastric decompression. No major complications were noted.

The procedures were successfully performed under general anesthesia by Interventional Radiologists. Under ultrasound and fluoroscopic guidance, a multipurpose drainage catheter was placed through the neck into the esophagus and positioned into the stomach. The catheter was then connected to drainage. Technical success was achieved in all the patients.

There are few palliative options for gastric decompression in patients who have advanced gynecologic malignancies. Both PEG and long-term nasogastric tube use have well-documented complications, especially in patients with large tumor burden and ascites. PTEG has been developed as a safe alternative with a low rate of complications and effective symptomatic relief in this patient population.