title: Percutaneous gastrostomy tube placement using a balloon catheter in patients with head and neck cancer.
abstract: BACKGROUND
  Patients with head and neck cancer frequently require gastrostomy feeding. The aim of this study was to evaluate the safety and feasibility of percutaneous radiologic gastrostomy with push-type gastrostomy tubes using a rupture-free balloon (RFB) catheter under computed tomography (CT) and fluoroscopic guidance in patients with head and neck cancer with swallowing disturbance or trismus.
  
  
  METHODS
  Percutaneous CT and fluoroscopic gastrostomy placement of push-type gastrostomy tubes using a RFB catheter was performed in consecutive patients with head and neck cancer between April 2007 and July 2010. The technical success, procedure duration, and major or minor complications were evaluated.
  
  
  RESULTS
  Twenty-one patients (14 men, 7 women; age range, 55-78 years; mean age, 69.3 years) underwent gastrostomy tube placement. The tumor location was the pharynx (n = 8), oral cavity (n = 7), and gingiva (n = 6). Gastrostomy was performed in 15 patients during treatment and 6 patients after treatment. Percutaneous radiologic gastrostomy was technically successful in all patients. The median procedure time was 35 ± 19 (interquartile range) minutes (range, 25-75). The average follow-up time interval was 221 days (range, 10-920 days). No major complications related to the procedure were encountered. No tubes failed because of blockage, and neither tube dislodgement nor intraperitoneal leakage occurred during the follow-up periods.
  
  
  CONCLUSIONS
  Percutaneous CT and fluoroscopic-guided gastrostomy with push-type tubes using a RFB catheter is a relatively safe and effective means of gastric feeding, with high success and low complication rates in patients with head and neck cancer in whom endoscopy was not feasible.
authors.affiliation: Department of Radiology, Yamaguchi University Graduate School of Medicine, Ube, Japan. tfujita@yamaguchi-u.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fujita
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tanabe
authors.forename: Taiga
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Washida
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kato
authors.forename: Etsushi
authors.initials: E
authors.lastname: Iida
authors.forename: Kensaku
authors.initials: K
authors.lastname: Shimizu
authors.forename: Naofumi
authors.initials: N
authors.lastname: Matsunaga
mesh_terms: D000368:Aged; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D057785:Catheters; D003680:Deglutition Disorders / Q000209:etiology; D004750:Enteral Nutrition / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D005881:Gingiva / Q000000981:diagnostic imaging / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000000981:diagnostic imaging / Q000601:surgery; D010614:Pharynx / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications; D015641:Radiography, Interventional / Q000009:adverse effects / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D014313:Trismus / Q000209:etiology