title: Percutaneous radiologic gastrostomy in patients with malignant pharyngoesophageal obstruction.
abstract: OBJECTIVE
  Percutaneous endoscopic gastrostomy is widely practiced, but we use interventional radiology techniques to perform percutaneous radiologic gastrostomy in cancer patients with conditions that prevent endoscope insertion due to pharyngoesophageal obstruction. This study retrospectively investigated the effectiveness of percutaneous radiologic gastrostomy at our hospital.
  
  
  METHODS
  We investigated the medical records of 105 patients who underwent percutaneous radiologic gastrostomy between 2001 and 2011. The technique used for percutaneous radiologic gastrostomy comprised insufflation to dilate the stomach via a nasogastric tube, followed by fluoroscopically guided puncture and gastrostomy tube placement. In patients for whom a nasogastric tube could not be inserted, the stomach was punctured with a fine needle under ultrasonographic guidance and insufflated via this puncture needle to achieve dilation.
  
  
  RESULTS
  Patients comprised 75 men and 30 women (mean age, 63 years). A nasogastric tube was used during percutaneous radiologic gastrostomy in 81 cases, but could not be used in 24. The percutaneous radiologic gastrostomy procedure was successful in all cases. Serious post-percutaneous radiologic gastrostomy complications comprised one case each of decreased hemoglobin requiring blood transfusion, pneumoperitonitis that was treated by a laparotomy and infected fistula requiring tube removal (3/105, 2.9%). Duration of gastrostomy tube placement was 1-731 days, and the outcome was death in 59 cases, hospital transfer in 23, tube removal in 18 and survival with gastrostomy tube in place in 5.
  
  
  CONCLUSIONS
  Serious complications requiring treatment occurred in 2.9% of cases in which percutaneous radiologic gastrostomy was performed, with mostly good effectiveness. Percutaneous radiologic gastrostomy is feasible even for patients in whom a nasogastric tube cannot be inserted.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan. 105824@aichi-cc.jp
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Inaba
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Yamaura
authors.forename: Yozo
authors.initials: Y
authors.lastname: Sato
authors.forename: Masataka
authors.initials: M
authors.lastname: Kashima
authors.forename: Mina
authors.initials: M
authors.lastname: Kato
authors.forename: Daisaku
authors.initials: D
authors.lastname: Inoue
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kurinobu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D004938:Esophageal Neoplasms / Q000150:complications / Q000473:pathology*; D005260:Female; D005471:Fluoroscopy; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods; D006258:Head and Neck Neoplasms / Q000150:complications*; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000150:complications / Q000473:pathology*; D015642:Radiology, Interventional; D012189:Retrospective Studies
keywords: malignant pharyngoesophageal obstruction; percutaneous radiologic gastrostomy