Gastrostomy tubes in patients with recurrent gynaecological cancer and intestinal obstruction.
OBJECTIVE
Women with recurrent gynaecological cancers who are not suitable for exenterative surgery commonly present with gastrointestinal dysfunction. This paper is a retrospective review of the use of gastrostomy tubes in such women.


METHODS
We performed a chart review of women with recurrent gynaecological cancer who had a gastrostomy tube placed between January 1991 and April 1998.


RESULTS
Thirty-nine women (mean age 53.2 years, range 17-82) had a gastrostomy tube placed. Twenty-eight (72%) had ovarian cancer, eight (21%) had cervical cancer, two had endometrial cancer and one had vaginal cancer. In 14 women a gastrostomy tube was placed as the sole procedure for palliation (11 elective, 3 emergency). In the remaining 25 women, who underwent major surgery, a gastrostomy tube was placed in anticipation of, or in the presence of, significant intestinal distension and expected prolonged post-operative ileus. Eleven women (28%) died without leaving hospital after their operation (median 11 days, range 2-36). All but one of the 28 women who left hospital had satisfactory oral intake. Twenty-one women (54%) died with the gastrostomy tube in place (median 28 days, range 2-157) and 18 (46%) had the gastrostomy tube removed (median 14.5 days, range 9-180), 13 of whom (33%) have since died (median 167 days, range 77 days-7 years). Five women (13%) are alive (median 2.2 years, range 10 months-4.5 years). There were no problems which required the gastrostomy tube to be removed.


CONCLUSIONS
Gastrostomy tubes have an important role in the treatment of women with recurrent gynaecological cancer, allowing gastric drainage and decompression without the disadvantages of nasogastric tubes.
Tsahalina
E
E
The Royal Marsden Hospital, London, UK.
Woolas
R P
RP
Carter
P G
PG
Chan
F
F
Gore
M E
ME
Blake
P M
PM
Shepherd
J H
JH
Barton
D P
DP
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy / Q000295:instrumentation*; D005833:Genital Neoplasms, Female / Q000150:complications / Q000601:surgery*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies