Wound implantation—a surgical hazard

Alagaratnam, T. T.; Ong, G. B.

doi:10.1002/bjs.1800641211

Cited by 57 publications

(37 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2 This technique does not require Complications of percutaneous endoscopic gastrostomy are relatively uncommon, but include local infection, hemorrhage, dislodgment, peritonitis, bowel perforation and aspiration pneumonia 15 Another rare complication that appears to be becoming more prevalent is the metastatic implantation of tumor at the PEG tube site. 6,14 The first case of gastric and abdominal wall metastasis secondary to PEG placement in a patient with head and neck cancer was reported in 1989. 6,15 Since the introduction of this technique, there have been at least 23 case reports of tumor seeding at the gastrostomy site.…”

Section: Discussionmentioning

confidence: 99%

“…6,14 The first case of gastric and abdominal wall metastasis secondary to PEG placement in a patient with head and neck cancer was reported in 1989. 6,15 Since the introduction of this technique, there have been at least 23 case reports of tumor seeding at the gastrostomy site. The mode of tumor spread to the gastrostomy site remains controversial and unproven.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Cancer metastatic to a PEG tube exit is a rare but serious complication of this procedure. [6][7][8][9][10][11][12][13][14] We report a case of a patient who underwent PEG placement prior to definitive chemoradiation for squamous cell carcinoma of right tonsil. Eight months post PEG closure (15 months postchemoradiotherapy), patient presented with an isolated biopsy proven metastasis at endoscopic gastrostomy (PEG) site.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Metastatic Implantation of Head and Neck Squamous Cell Cancer at PEG Tube Site Exit— An Unusual Relapse Site: A Case Report and Review of Literature

Palwe¹,

Talpatra²,

Mahantshetty³

et al. 2011

International Journal of Head and Neck Surgery

View full text Add to dashboard Cite

Background The placement of percutaneous endoscopic gastrostomy (PEG) tubes is a common procedure in patients with head and neck cancer who require adequate nutrition because of the inability to swallow before or after surgery and adjuvant therapies. A potential complication of percutaneous endoscopic gastrostomy tubes is the metastatic spread from the original head and neck tumor to the gastrostomy site. Methods This is a case of a 55-year-old male with a (cT4N3M0) stage IV squamous cell carcinoma of the oropharynx who underwent percutaneous endoscopic gastrostomy tube placement prior to commencement of definitive chemoradiation therapy and 7 months thereafter developed metastatic spread to the gastrostomy site. Tumor was treated with radiation therapy. A review of the published literature regarding the subject is done. The pull-through method of gastrostomy tube placement had been used in our patient as well as in the majority of the other cases reviewed in the literature. Conclusions There is a small but definite risk for tumor implantation in the gastrostomy site when using the pull technique in patients with active head and neck cancer. The direct implantation of tumor through instrumentation is the most likely explanation for metastasis; however, hematogenous seeding is also a possibility. Careful assessment of the oropharynx and hypopharynx before PEG tube placement and the use of alternative techniques for enteral access in patients with untreated or residual malignancy are recommended to minimize this risk.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Metastatic Implantation of Head and Neck Squamous Cell Cancer at PEG Tube Site Exit— An Unusual Relapse Site: A Case Report and Review of Literature

Palwe¹,

Talpatra²,

Mahantshetty³

et al. 2011

International Journal of Head and Neck Surgery

View full text Add to dashboard Cite

show abstract

“…Subsequently, tumor seeding of incisions has been implicated as contributing to local recurrence after surgical therapy for a variety of malignancies, with head and neck, breast, and colon being among the most frequently cited primary tumors. 13 Such occurrences are apparently very rare in gynecologic malignancies, but nonetheless case reports can be found for ovarian, endometrial, and cervical cancers.6.14-22 Dv orak,I4 in his review from 1930, references case reports from Olshausen in 1899 and 1902 describing probable implantation metastases in patients with both benign and malignant ovarian tumors, respectively, the latter occurring in a laparotomy scar. In 1965 Cole et al" described multiple subcutaneous metastases after paracentesis in a patient with advanced ovarian carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Isolated incisional metastases after intraperitoneal radioactive chromic phosphate therapy for ovarian carcinoma

Kohler

Soper

Allan

et al. 1991

Cancer

View full text Add to dashboard Cite

Two women developed apparently isolated recurrences of ovarian carcinoma involving prior incisions after receiving intraperitoneal radioactive chromic phosphate (P‐32) adjuvant therapy for early epithelial ovarian carcinoma. Both are alive without evidence of disease at second‐look laparotomy after surgical resection of the abdominal wall metastases and cisplatin‐based combination chemotherapy. Mechanisms of cutaneous and incisional implantation metastases are discussed. Adjuvant therapy with intraperitoneal P‐32 is unable to provide systemic therapy for occult metastatic disease. The favorable outcome in these cases probably reflects limited tumor burden at the time of recurrence and stands in stark contrast to other cases of soft tissue recurrences of ovarian carcinoma reported previously.

show abstract

“…This type of metastasis was first described in 1977 in the skin and 1989 in the abdominal wall [27,28] . In a prospective trial with 50 patients suffering from oropharyngeal or esophageal cancer, Ellrichmann et al [29] demonstrated tumor seeding to the PEG insertion site in cytology in 9.4% of cases.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy in Direct Puncture Technique: When, Why and How?

Schaefer¹,

Vivaldi²,

Herbold³

et al. 2016

Dig Surg

View full text Add to dashboard Cite

Background: Percutaneous endoscopic gastrostomy (PEG) placed in the pull through (PT) technique is a common procedure to restore enteral feeding in patients with swallowing disorders. Limitations of this technique are patients with obstruction of the pharynx or esophagus or with an esophageal stent. We report our experience with the direct puncture (DP) PEG device. Methods: We included 154 patients (55 women). One hundred forty patients had cancer. After passing the endoscope into the stomach, 4 gastropexies were performed with a gastropexy device and the PEG was placed with the introducer method. After 1 month, the sutures were removed and a constant gastrocutaneous fistula had been created and the new catheter could be placed safely. Results: The DP PEG was successfully placed in all patients. Overall complication rate was 11% (minor: 6%, major: 5%). The most common event was tube dislocation (40 cases). In 5 cases of dislocation, this resulted in a major complication with injuring the gastric wall and the necessity for surgical treatment. Conclusions: The DP PEG system is safe, and can be used in cases in which a standard PT PEG is not feasible. To avoid dislocation, strict adherence to a post-interventional protocol is highly recommended.

show abstract

Wound implantation—a surgical hazard

Abstract: A review of the literature on wound implantation together with a report on an unusual case of irnplantation of squamous carcinoma at the site of a gastrostomy is presented.

Cited by 57 publications

References 32 publications

Metastatic Implantation of Head and Neck Squamous Cell Cancer at PEG Tube Site Exit— An Unusual Relapse Site: A Case Report and Review of Literature

Metastatic Implantation of Head and Neck Squamous Cell Cancer at PEG Tube Site Exit— An Unusual Relapse Site: A Case Report and Review of Literature

Isolated incisional metastases after intraperitoneal radioactive chromic phosphate therapy for ovarian carcinoma

Percutaneous Endoscopic Gastrostomy in Direct Puncture Technique: When, Why and How?

Contact Info

Product

Resources

About