Percutaneous endoscopic gastrostomy by head and neck surgeons

Area of Science:

• Otolaryngology-Head and Neck Surgery
• Gastroenterology
• Surgical Procedures

Background:

• Percutaneous endoscopic gastrostomy (PEG) tube placement is a common procedure for nutritional support.
• Traditionally performed by gastroenterologists and general surgeons, radiologists also perform fluoroscopically guided placements.
• Head and neck surgeons, despite expertise in esophagoscopy and the Seldinger technique, have been slow to adopt PEG tube placement.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous endoscopic gastrostomy tube placement by head and neck surgeons.
• To assess the role of head and neck surgeons in providing comprehensive care for head and neck cancer patients requiring nutritional support.
• To determine the feasibility of integrating PEG tube placement into otolaryngology-head and neck surgery training.

Main Methods:

• Retrospective review of 41 percutaneous endoscopic gastrostomies performed in 39 patients by the Head and Neck Service at Stanford Medical Center between July 1992 and August 1995.
• Analysis of patient demographics, indications for the procedure, and complication rates.
• Procedures were performed by head and neck surgeons utilizing their expertise in esophagoscopy and the Seldinger technique.

Main Results:

• No major complications were reported in the 41 procedures.
• Two patients required intraoperative tube replacement (one for chronic infection, one for tube damage).
• Minor complications included local irritation at the surgical site in 2 (5.1%) patients.

Conclusions:

• Head and neck surgeons can safely and effectively perform percutaneous endoscopic gastrostomy tube placement.
• Integrating PEG tube placement into otolaryngology-head and neck surgery training can enhance comprehensive patient care.
• This procedure offers a valuable means of supplemental feeding for head and neck cancer patients and neurologically impaired individuals.