Percutaneous radiologic gastrostomy via nasopharyngeal intubation for the treatment of patients with complete malignant pharyngoesophageal obstruction.
OBJECTIVE
For patients with complete malignant pharyngoesophageal obstruction (CMPO), percutaneous radiologic gastrostomy (PRG) under ultrasound/CT guidance can complicate it to cause failure due to unsatisfied stomach filling. In this study, we retrospectively investigated whether PRG via nasopharyngeal intubation is feasible and effective for these patients.


METHODS
PRG via nasopharyngeal intubation was attempted in 21 patients with CMPO (mean 70.8 ± 8.23 years). The technique comprised a dilation of the stomach via nasopharyngeal intubation using a catheter, followed by fluoroscopically guided puncture and gastrostomy tube placement. Complications including hemorrhage, peritonitis, gastrojejunocolic fistula, infection of puncture site, tube blocking and outleakage was observed during and after the procedure.


RESULTS
A 5F catheter was successfully inserted to the stomach under fluoroscopical guidance and subsequent PRG was performed in all 21 patients. Minor complications occurred in 14.3% patients including mild infection of the fistula in 1, tube blocking in 1 and unexpected tube drawing out in 1. Follow-up nutrition indexes revealed obvious improved nutrition compared to before PRG (P < 0.05).


CONCLUSIONS
PRG via nasopharyngeal intubation was simple, feasible and effective for patients with CMPO.
Jun
J
Cao
Yang
Y
He
Hong-Qiang
HQ
Liu
Sai-Bo
SB
Wang
Bao-Cheng
BC
Zhao
Ying-Sheng
YS
Cheng
D000368:Aged; D002404:Catheterization; D057785:Catheters; D004867:Equipment Design; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000150:complications*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010166:Palliative Care; D018579:Patient Selection; D010608:Pharyngeal Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011677:Punctures; D015641:Radiography, Interventional; D012189:Retrospective Studies; D016896:Treatment Outcome