Percutaneous endoscopic gastrostomy in patients undergoing resection for oral tumors: a retrospective review of complications and outcomes.
OBJECTIVE
The use of a percutaneous endoscopic gastrostomy (PEG) in patients undergoing resection for oral tumors is not universal, and varying complication rates have been reported. This study reviews our experience with the use of a PEG as an adjunct in this setting.


METHODS
The records of patients treated for oral tumors by oral and maxillofacial surgery were reviewed retrospectively. All patients undergoing resection for oral tumors and having a PEG were included. Patient age, gender, disease type, and stage, as well as type of operation, were recorded. Data obtained included the timing of PEG placement, duration of PEG use, and PEG complications. Patient weight and body mass index (BMI) were abstracted when recorded preoperatively and about 2 weeks and between 4 and 8 weeks postoperatively. Weight and BMI results were subjected to statistical analysis.


RESULTS
Fifty PEGs were placed in 49 patients with oral tumors. The mean age of the patients was 61 years. More than 90% of tumors were squamous cell carcinomas. Most PEG tubes were placed at the time of resection by 1 surgeon and were retained for a mean duration of 114 days. A minor complication rate of 10% and a major complication rate of 8% were noted. Weight decreased significantly by 2.9% from preoperative level to week 2, but there was no other significant difference found between any other weight or BMI measurement. Incidental findings on PEG placement included Barrett's metaplasia in one patient and gastric adenocarcinoma in another.


CONCLUSIONS
The use of PEG in patients with oral tumors at our institution was found to be effective in maintaining adequate nutrition, as assessed by weight and BMI, during recovery and convalescence. There is an acceptable low complication rate. Use of an experienced endoscopist and PEG placement at the time of resection are advocated.
Chandu
A
A
Oral and Maxillofacial Surgery, School of Dental Science, Austin and Reparation Medical Centre, University of Melbourne, 711 Elizabeth Street, Melbourne, Australia.
Smith
A C H
AC
Douglas
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004750:Enteral Nutrition / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects; D005774:Gastrostomy / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D009752:Nutritional Status; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss