Complications of fluoroscopically guided percutaneous gastrostomy with large-bore balloon-retained catheter in patients with head and neck tumors.
OBJECTIVE
To review the complications, mortality rate and nutritional status of patients with head and neck cancer after fluoroscopically guided percutaneous gastrostomy (FPG).


METHODS
We retrospectively recruited 110 patients who had undergone FPG using 14-French balloon-retained catheters. The mortality rate, procedural and catheter-related complications, and Eastern Cooperative Oncology Group performance status were reviewed. Peritonitis, abscess, septicemia and bleeding were defined as major complications. Tube-related problems, including dislodgment, obstruction, leakage, vomiting and infection, were classified as minor complications.


RESULTS
Patients were stratified according to Eastern Cooperative Oncology Group performance status as follows: grade 0 (n=6); grade 1 (n=22); grade 2 (n=44); grade 3 (n=29); and grade 4 (n=7). The respective complication rates were 21%, 24%, 26%, and 29% for grades 1-4; however, there were no significant intergrade differences. The rates of major and minor complications were 1.9% and 20.0%, respectively. A total of 47 (43.5%) patients succumbed due to cancer deterioration; however, there was no gastrostomy-induced mortality. The catheter-occlusion rate of 3.7% in this cohort was significantly lower than that reported in other pigtail-retained gastrostomy studies.


CONCLUSIONS
FPG is a safe method with low mortality and complication rate for constructing long-term enteral access in patients with head and neck cancer and esophageal abnormalities, who have no endoscopic access to the stomach.
Chan
Siu-Cheung
SC
Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Chu
Chiu-Wing Winnie
CW
Liao
Chun-Ta
CT
Lui
Kar-Wai
KW
Ko
Sheung-Fat
SF
Ng
Shu-Hang
SH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D002408:Catheters, Indwelling; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome