title: Local infection after percutaneous endoscopic gastrostomy in ENT tumor patients: evaluation of the influence of the abdominal thickness and other parameters.
abstract: BACKGROUND
  The percutaneous endoscopic gastrostomy is the method of choice in patients with advanced tumours of the upper aerodigestive tract, after surgery or before radiochemotherapy, for the establishment of a sufficient nutrition therapy. The aim of this observation study was to investigate, to what extent the abdominal thickness and other factors have an influence on the rate of peristomal infection after a percutaneous endoscopic gastrostomy.
  
  
  METHODS
  Percutaneous endoscopic gastrostomy was performed on 135 patients in 2008-2009. 101 patients were fully evaluated and included in the study. The different layers of the abdominal wall were measured with B-scan ultrasound (7.5 MHz). Furthermore, potential patient-related risk factors (gender, age, nutritional status (Body Mass Index, Nutritional Risk Score, total serum protein, the tumor stage and presence of Diabetes mellitus) and their effect on the occurrence of a wound infection were evaluated.
  
  
  RESULTS
  A peristomal infection was documented in 21.8% of the patients (22/101). Serious complications were not observed. There were no statistically significant predictors for the occurrence of a peristomal infection detected.
  
  
  CONCLUSIONS
  The hypothesis that the abdominal wall thickness has an influence on the rate of the peristomal infection is not confirmed. This is of clinical relevance in patients, who are still in a relatively good general and nutritional condition before radiochemotherapy. The intraoperative ultrasonography can be used to guide catheter insertion while providing a safe adjunct to confirm proper tube placement and minimizing the risk of inadvertently entering adjacent intraabdominal organs.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Unsiversity of Erlangen, Waldstrasse 1, 91054 Erlangen, Germany. konstantinos.mantsopoulos@uk-erlangen.de
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Mantsopoulos
authors.forename: Johannes
authors.initials: J
authors.lastname: Zenk
authors.forename: Peter C
authors.initials: PC
authors.lastname: Konturek
authors.forename: Heinrich
authors.initials: H
authors.lastname: Iro
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D015992:Body Mass Index; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects*; D005774:Gastrostomy / Q000009:adverse effects*; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000628:therapy*; D006801:Humans; D007327:Insufflation; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000473:pathology; D013530:Surgical Wound Infection / Q000209:etiology*; D014463:Ultrasonography