Percutaneous endoscopic gastrostomy at the time of tumour resection in advanced oral cancer

The prospective experience of a maxillofacial surgeon with the percutaneous endoscopic gastrostomy technique

“…The rate of successful PEG placement in the current study of 97% is comparable with a large meta-analysis of the gastroenterological literature by WOLLMAN et al 40 (95.7%) and current head and neck practice (90-98.5%) 3,5,12,17,18,37,38 . The majority of patients with common gastrointestinal pathology, including partial gastrectomy, were successfully treated.…”

“…The complication rates are similar irrespective of the technique used, whether this is the common pull (Ponsky) method, the push (SachsVine) method or the direct introducer (Russell) method. In head and neck surgical practice the incidence of major complications ranges from 0% to 35% and minor complications from 8% to 17.5% 3,5,12,17,18,37,38 . The incidence of major complications appears to be higher when the operator is a trainee, whether a surgeon or gastroenterologist 6,24,38 .…”

“…The PEG is commonly inserted by a gastroenterologist 40 or a gastrointestinal or general surgeon 3,5,6,13 . It is occasionally inserted by a specialist nurse 22 , otolaryngologist 12,17,37 or maxillofacial surgeon 18 .…”

Single Port Access (SPA™) gastrostomy tube in patients unable to receive percutaneous endoscopic gastrostomy placement

“…PEG should also be avoided in patients with massive ascites or severe malnutrition as tract formation is impaired and leakage may result. A serious but rare complication that has been reported in head and neck cancers is seeding of the tumor at the PEG site [9].…”

Laparoscopic Witzel gastrostomy—a reappraised technique

“…A serious but rare complication that has been reported in head and neck cancers is seeding of the tumor at the PEG site [5]. This is probably the result of implantation of cancer cells from the primary tumor into the abdominal wall by pulling the tumor through with the catheter.…”