LONG-TERM PERCUTANEOUS ENDOSCOPIC GASTROSTOMY AND TUMORS OF THE UPPERAERODIGESTIVE TRACT

Percutaneous endoscopically controlled gastrostomy (PEG) enables patie nts suffering from a tumor of the upper aerodigestive tract to receive direct gastric feedings.The procedure also avoids the social stigma o f a nasal feeding tube.The results of 630 PEG procedures used in 555 p atients suffering from various head and neck cancers are reported.The mean age of the patients was 58.0 years with a range from 11 to 92 yea rs. The PEG procedure was carried out under local anesthesia in 60% of the cases and with general anesthesia in 40%. In 512 patients the ini tial PEG procedure was successful while 43 of the patients required a second PEG procedure after loss of the PEG. In 19 patients the PEG pro cedure was not successful because of tumor obstruction or it was not p ossible to perform endoscopy.Twenty-four patients were successfully tr eated in a second or third session.Altogether 97% (n = 563) of all 555 patients and 92% (n = 579) of all PEG procedures were successful.The mean duration of PEG use was 243 days (range:0-2271 days).ln 66 patien ts (10.5%) complications occurred but severe complications developed i n only 8 patients (1.3%). Operative interventions were necessary in tw o cases. No deaths resulted from the PEG.These findings show that the PEG technique is safe to do with only few complications when performed by a skilled team.