RADIOLOGIC PERCUTANEOUS GASTROSTOMY - RESULTS IN 56 PATIENTS WITH HEAD AND NECK-CANCER

Objective: The establishment of a direct enteral feeding route is crit ical in the overall treatment of many patients with head and neck canc er. Use of radiologic percutaneous gastrostomy (RPG), the newest techn ique for gaining enteral access, has not been studied in such patients extensively. This study evaluated the indications, technique, success rate, and complications associated with RPG in patients with head and neck cancer. Study Design: Retrospective. Methods: A comprehensive ch art review was undertaken of 56 patients with head and neck cancer tre ated at a tertiary care institution who had undergone successful or at tempted RPG at some point during their treatment course. Results: Most study patients had advanced oropharyngeal squamous cell carcinoma. Th e most frequent indications for RPG were dysphagia/aspiration followin g tumor resection (n = 26) and dysphagia following completion of singl e- or combined-modality therapy (n = 22). The success rate of attempte d RPGs was 98.2%. The overall complication rate for RPG was 12.7% (10. 9% minor and 1.8% major). Conclusions: RPG is a valuable tool for esta blishing enteral nutrition in patients with head and neck cancer. Adva ntages of RPG include high success rate despite obstructing lesions, l ow complication rate, time efficiency and scheduling ease compared wit h intraoperative percutaneous gastrostomy (PEG) by a second team, no r eported tumor seeding of the tube site, and the fact that postoperativ e RPG allows for more accurate selection of patients who require a gas trostomy tube.