title: Early initiation of enteral feeding in cancer patients after outpatient percutaneous fluoroscopy-guided gastrostomy catheter placement.
abstract: OBJECTIVE
  To report the results of early enteral feeding in patients with cancer after outpatient placement of a percutaneous fluoroscopy-guided gastrostomy (PFG).
  
  
  METHODS
  From January 2008 through December 2008, 121 consecutive patients with cancer underwent outpatient placement of a PFG for nutrition. Of these patients, 118 patients met criteria for early feeding, and 113 were successfully fed early (after at least 3 hours). Of the patients fed early, 5 had insufficient follow-up for further analysis leaving 108 patients for outcomes analysis. After placement of the PFG, patients were put on low-wall suction via the PFG for 1 hour followed by feeding via the PFG at least 3 hours after placement. Follow-up evaluation was done the next business day. The medical records were reviewed for 30-day outcomes of early feeding, technical aspects of the procedures, and complications.
  
  
  RESULTS
  After placement of the PFG, 98% (118 of 121) of patients met criteria for early feeding, and 93% (113 of 121) of patients were successfully fed early. The median time between the end of the procedure and initiation of feeding was 4 hours (interquartile range, 3.7-4.4 h). The 30-day minor complication rate was 14% (15 of 108), and the 30-day major complication rate was 1% (1 of 108). No complications were directly attributable to early feeding.
  
  
  CONCLUSIONS
  Early initiation of tube feedings after outpatient placement of a PFG was well tolerated in patients with cancer and carried comparable risks to previously reported results using traditional delayed feeding protocols. Early feeding provided patients with prompt enteral nutrition and eliminated the need for routine hospital admission after the procedure.
authors.affiliation: Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1471, Houston, TX 77230.
authors.forename: Sharjeel H
authors.initials: SH
authors.lastname: Sabir
authors.affiliation: Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1471, Houston, TX 77230.
authors.forename: Ryan
authors.initials: R
authors.lastname: Armstrong
authors.affiliation: Department of Health Services Research, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1471, Houston, TX 77230.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Elting
authors.affiliation: Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1471, Houston, TX 77230.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Wallace
authors.affiliation: Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1471, Houston, TX 77230.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Interventional Radiology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1471, Houston, TX 77230. Electronic address: alda.tam@mdanderson.org.
authors.forename: Alda L
authors.initials: AL
authors.lastname: Tam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D002408:Catheters, Indwelling; D004750:Enteral Nutrition; D005260:Female; D005471:Fluoroscopy; D005774:Gastrostomy / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D009752:Nutritional Status; D015641:Radiography, Interventional / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult