Role of percutaneous gastrostomy tubes in the postoperative care of patients with cancer of the oral cavity and oropharynx

Objective: The purpose of this study was to document the use and complicati ons of gastrostomy tubes placed following surgery for oral cancer at our in stitution and to determine preoperative predictors of the procedure. Method: A retrospective chart review of 105 patients treated surgically for oral cancer between March 1990 and June 1995 at St. Joseph's Health Care C entre, London, Ontario was conducted. Twenty patients were studied with reg ard to timing, indication, and morbidity (n = 24) of the procedure. Regress ion analysis was performed regarding preoperative predictors of postoperati ve gastrostomy including tumour site and stage, and the percentage of tongu e resected. Outcome measures included time from surgery to gastrostomy, len gth of postoperative hospital stay, time gastrostomy tube in situ, complica tions of gastrostomy, and the predicted risk of postoperative gastrostomy t ube. Results: The mean time to gastrostomy tube placement was 17.4 days, and the mean length of hospital stay in gastrostomy patients was 26.8 days. Gastro stomy was temporary in 55% of patients. No significant complications of per cutaneous gastrostomy were encountered. Oropharyngeal tumour site and advan ced T stage were predictive of the need for postoperative gastrostomy. Conclusions: In oral cavity and oropharyngeal cancer patients treated surgi cally, early postoperative percutaneous gastrostomy tube placement is indic ated in those at high risk for significant postoperative dysphagia.