title: Esophagectomy in patients with prior percutaneous endoscopic gastrostomy tube placement.
abstract: BACKGROUND
  The impact of preoperative percutaneous endoscopic gastrostomy (PEG) tube placement in patients undergoing esophagectomy is uncertain.
  
  
  METHODS
  A retrospective review was performed in consecutive patients who underwent esophagectomy. Patients were divided into groups based on whether or not they had preoperative PEG placement.
  
  
  RESULTS
  One hundred seventeen patients were studied, 102 without (PEG-) and 15 with PEG+ before PEG tube placement. The overall morbidity and mortality rates were 38% and 3%, respectively. The use of a gastric conduit was similar between groups (94% PEG- vs 87% PEG+, P = .27), and the presence of a PEG before PEG tube placement was not prohibitive in any case. Anastomotic leak rates were similar between groups (11% PEG- vs 15% PEG+, P = .65), and there were no leaks from previous PEG sites.
  
  
  CONCLUSIONS
  It appears that preoperative PEG tube placement has no adverse effect on the performance of esophagectomy and may be considered in highly selected patients with poor nutritional status.
authors.affiliation: Grand Rapids Medical Educations Partners, General Surgery Residency Program, Grand Rapids, MI, USA; Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, MI, USA. Electronic address: paul.wright@grmep.com.
authors.forename: Gerald Paul
authors.initials: GP
authors.lastname: Wright
authors.affiliation: Grand Rapids Medical Educations Partners, General Surgery Residency Program, Grand Rapids, MI, USA; Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, MI, USA.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Foster
authors.affiliation: Grand Rapids Medical Educations Partners, General Surgery Residency Program, Grand Rapids, MI, USA; Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, MI, USA; Spectrum Health Medical Group, Division of Surgical Oncology, Grand Rapids, MI, USA.
authors.forename: Mathew H
authors.initials: MH
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004935:Esophageal Diseases / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000150:complications / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000628:therapy; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Anastomotic leak; Esophageal cancer; Esophagectomy; Gastrostomy tube; Percutaneous endoscopic gastrostomy