title: Percutaneous endoscopic gastrostomy tube placement by otorhinolaryngologist-head and neck surgeons.
abstract: CONCLUSIONS
  Percutaneous endoscopic gastrostomy (PEG) tube placement by an otorhinolaryngologist-head and neck surgeon is a feasible procedure with logistical advantages for the patient. Patient selection, co-morbidities, and the prognosis of the underlying disease are factors determining the outcome. Patient evaluation by a multidisciplinary team, with a gastroenterologist surgeon as a technical adviser, is proposed.
  
  
  OBJECTIVE
  PEG tube placement offers an alternative to enteral nutrition. We aimed to analyze complication rates after PEG tube placement in order to evaluate the changed management policy.
  
  
  METHODS
  This was a retrospective review of complication rates in two patient cohorts with consecutive PEG tube placement at the Departments of Otorhinolaryngology - Head and Neck Surgery (group I, n = 120) and Surgery (group II, n = 172) at Helsinki University Central Hospital, Helsinki, Finland. Data were collected on the patients' age, sex, preoperative condition, tumor site and stage, preoperative laboratory parameters, coexisting medical diagnoses, indication and date for PEG tube placement, complications, time of PEG use, follow-up time, and clinical status at the last follow-up.
  
  
  RESULTS
  The only baseline differences between the cohorts were a higher ASA classification and fewer prophylactic PEG tubes in group II. The rate of major complications was 7.5% in group I and 13.9% in group II; in group I the rate of minor complications was 25%, compared with 15% in group II; and the procedure-related mortality rate was 0.8% in group I and 0.5% in group II. The differences were not significant (p = 0.105-0.795).
authors.affiliation: Departments of Otorhinolaryngology - Head and Neck Surgery.
authors.forename: Leif J J
authors.initials: LJ
authors.lastname: Bäck
authors.forename: Alexander
authors.initials: A
authors.lastname: Benders
authors.forename: Petra
authors.initials: P
authors.lastname: Pietarinen
authors.forename: Harri
authors.initials: H
authors.lastname: Keski-Säntti
authors.forename: Mari
authors.initials: M
authors.lastname: Markkanen-Leppänen
authors.forename: Marianne
authors.initials: M
authors.lastname: Udd
authors.forename: Jorma
authors.initials: J
authors.lastname: Halttunen
authors.forename: Antti A
authors.initials: AA
authors.lastname: Mäkitie
authors.forename: Leena
authors.initials: L
authors.lastname: Kylänpää
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D004724:Endoscopy; D004750:Enteral Nutrition; D005240:Feasibility Studies; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods; D006258:Head and Neck Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Head and neck cancer; complication; mortality; prophylactic; therapeutic