The laparoscopic Janeway gastrostomy. An alternative technique when percutaneous endoscopic gastrostomy is impractical

Background and Study Aims: Today, percutaneous endoscopic gastrostomy (PEG) is the standard procedure for ensuring safe feeding access. In the case of advanced hypopharyngeal and esophageal carcinomas, it may not be feasible to pass an existing stenosis by endoscopy. The aim of this prospective stud y was: to investigate the laparoscopic Janeway gastrostomy as an alternativ e technique for guaranteeing feeding access in these: instances, Patients and Methods: Between May 1993 and December 1999, 21 patients under went laparoscopic Janeway gastrostomies. Indications were extended incurabl e tumors of the hypopharnyx (n=12) and esophagus (n=9) which rendered oral nutrition impossible and did not allow passage by the endoscope, Results: The mean operative time was 38 minutes (range 24-50), No procedure -related intraoperative or postoperative complications were observed. All p atients recovered quickly from surgery and the gastrostomies functioned wel l in ail cases until the death of the patients. Conclusion: The laparoscopic Janeway gastrostomy is a safe and simple techn ique for palliative feeding access, avoiding a laparotomy in patients in wh om percutaneous endoscopic placement is impractical.