Complications of Percutaneous Endoscopic Gastrostomy Tube Insertion in Cancer Patients: A Retrospective Study

Mansoor, Hala; Masood, Muhammad Adnan; Yusuf, Muhammed Aasim

doi:10.1007/s12029-014-9630-y

Cited by 12 publications

(13 citation statements)

References 43 publications

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“…In the eight retrospective series based around an index case of seeding, seeding was observed in 15 of 1742 patients with head and neck cancer (0.86%). In contrast, only two cases were identified in the randomized trial and the remaining prospective and retrospective series (2/3049; 0.07%). Combining both sets of data, the overall incidence of seeding in patients with head and neck cancer was 0.35% (17/4791) and 0.25% (1/397) in those with oesophageal cancer.…”

Section: Resultsmentioning

confidence: 94%

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Tumor implantation following percutaneous endoscopic gastrostomy insertion for head and neck and oesophageal cancer: Review of the literature

Rowell

2019

Head & Neck

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Background Because of publication bias, there is uncertainty about the true incidence of tumor seeding or implantation in patients with head and neck or oesophageal cancer undergoing percutaneous endoscopic gastrostomy (PEG) insertion. Methods In order to obtain a more reliable estimate of risk, a systematic review was undertaken. Randomized or non‐randomized studies and case reports were identified by electronic searching. A risk of bias assessment was carried out for each study. Results Ninety‐eight cases from 74 published case reports and 1 unpublished case were identified. Synchronous distant metastases were present in 37%. Analysis of case series (6192 patients) considered to carry a moderate risk of bias suggests an incidence of seeding after PEG insertion of 0.32%. Studies carrying a lower risk of bias indicate a risk of seeding closer to 1 in 2000. Conclusion The true risk of seeding after PEG insertion is probably less than 1 in 1000.

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Section: Resultsmentioning

confidence: 94%

“…Data from the randomized trial, the 27 retrospective and 2 prospective case series are summarized in Table .…”

Section: Resultsmentioning

confidence: 99%

Tumor implantation following percutaneous endoscopic gastrostomy insertion for head and neck and oesophageal cancer: Review of the literature

Rowell

2019

Head & Neck

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“…The most current literature on GT use in cancer comes from studies of adults with head and neck cancers . The safety and efficacy of GT use in children with cancer has not been widely investigated, but existing studies support it as an effective method of reversing malnutrition or preventing weight loss …”

Section: Indication and Insertionmentioning

confidence: 99%

“…Reported complication rates associated with GT insertion in children with cancer are high (60%–90%) compared with rates reported in adults with cancer (predominantly head and neck cancer) . Reports of complication rates of GT insertion in children with cancer compared with other children (predominantly with neurological impairment) are conflicting.…”

Section: Complicationsmentioning

confidence: 99%

Gastrostomy tube use in children with cancer

McGrath

Hardikar

2019

Pediatric Blood & Cancer

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Children with cancer are at risk of malnutrition, which can impair critical childhood processes of growth and development and contribute to poor health outcomes. Enteral nutrition can effectively ameliorate malnutrition or weight loss in children with cancer; however, published nutrition support algorithms contain minimal specific information on gastrostomy tube use, and current literature is limited. Decisions about gastrostomy tube insertion in children with cancer can be challenging. Consideration of gastrostomy tube insertion is only appropriate in children with long‐term dependence on enteral nutrition, particularly when nasogastric tube insertion is predicted or proven to be problematic. Specific indications for patient selection are unclear, and referring clinicians may be unaware of important absolute and relative contraindications. Complications are predominantly minor in nature; however, reported rates are high. Morbidity must be weighed carefully against the need and anticipated duration of enteral nutrition support, and further research in this area is needed.

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“…Recent studies observed in‐hospital mortality rates of up to 11% in patients who received PEG tubes . A significant part of complications during PEG placement is related to periprocedural events, such as cardiopulmonal failure during endoscopic sedation …”

Section: Introductionmentioning

confidence: 99%

Capnography monitoring of non‐anesthesiologist provided sedation during percutaneous endoscopic gastrostomy placement: A prospective, controlled, randomized trial

Peveling‐Oberhag

Michael

Tal

et al. 2019

J of Gastro and Hepatol

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Background and Aim A number of studies were able to show a reduction of hypoxemia episodes during procedural sedation through the use of capnography (CA). The present study investigates the number of episodes of hypoxemia during percutaneous endoscopic gastrostomy (PEG) placement with propofol sedation comparing standard monitoring (SM) versus SM with additional CA surveillance. Methods In this single center randomized controlled trial, 150 patients were prospectively randomized 1:1 in either the SM group or the CA group after stratification for ASA class, PEG method (push or pull method), presence of head and neck tumor, and tracheostomy. CA analysis was performed for all patients but was blinded for the endoscopic team in the SM group. Results In the SM group, 57% episodes of hypoxemia (SpO2 < 90% for > 15 s) and 41% episodes of severe hypoxemia (SpO2 < 85% for > 15 s) were observed in comparison with 28% and 20% in the CA group, respectively. Odds ratios for hypoxemia and severe hypoxemia were 0.29 (confidence interval 0.15–0.57; P = 0.0005) and 0.35 (confidence interval 0.17–0.73; P = 0.008) in favor of the CA group. On average, CA was able to detect imminent mild and severe hypoxemia 83 and 99 s before standard monitoring. Standard monitoring represented an independent risk factor for hypoxemia and severe hypoxemia. Conclusions Respiratory complications of sedation during PEG placement are frequent events. CA is able to detect imminent hypoxemia at an early time point. This allows an early intervention and consecutively the avoidance of mild and severe hypoxemia. Therefore, CA monitoring can be recommended particularly during PEG insertion procedures.

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Complications of Percutaneous Endoscopic Gastrostomy Tube Insertion in Cancer Patients: A Retrospective Study

Cited by 12 publications

References 43 publications

Tumor implantation following percutaneous endoscopic gastrostomy insertion for head and neck and oesophageal cancer: Review of the literature

Tumor implantation following percutaneous endoscopic gastrostomy insertion for head and neck and oesophageal cancer: Review of the literature

Gastrostomy tube use in children with cancer

Capnography monitoring of non‐anesthesiologist provided sedation during percutaneous endoscopic gastrostomy placement: A prospective, controlled, randomized trial

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