title: Laparoscopic-assisted percutaneous endoscopic gastrostomy tube insertion in the immediate post-partum period for head and neck cancer.
abstract: Percutaneous endoscopic gastrostomy (PEG) tube placement serves as a well-tolerated and efficacious technique for long-term enteral access in patients with medical conditions precluding oral food intake. The nutritional optimisation of patients with oral cancer is mostly achieved via PEG tube placement. However, certain special situations, such as pregnancy and the immediate post-partum period, may render the placement of PEG tubes to be a challenge. A 28-year-old pregnant female patient presented to us with the diagnosis of squamous cell carcinoma of the tongue during her third trimester. Definitive surgical resection was planned post-delivery along with simultaneous PEG tube placement. Immediately following delivery via an elective Caesarean section, she successfully underwent laparoscopic-assisted PEG tube placement. A gravid uterus or an immediately post-partum distended uterus poses significant difficulties whilst attempting PEG insertion. However, laparoscopic-assisted PEG insertion in a controlled setting may make the process safer to perform.
authors.affiliation: Final Year, Medical College, Aga Khan University, Karachi, Pakistan.
authors.forename: Adil Aijaz
authors.initials: AA
authors.lastname: Shah
authors.affiliation: Department of Otolaryngology, Aga Khan University, Karachi, Pakistan.
authors.forename: Shabbir
authors.initials: S
authors.lastname: Akhtar
authors.affiliation: Department of Obstetrics and Gynecology, Aga Khan University, Karachi, Pakistan.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Zuberi
authors.affiliation: Final Year, Medical College, Aga Khan University, Karachi, Pakistan.
authors.forename: Kamran
authors.initials: K
authors.lastname: Ali
authors.affiliation: 1st Year, Medical College, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Dania Aijaz
authors.initials: DA
authors.lastname: Shah
authors.affiliation: Department of Surgery, Aga Khan University, Karachi, Pakistan.
authors.forename: Amir Hafeez
authors.initials: AH
authors.lastname: Shariff
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007441:Intubation, Gastrointestinal; D010535:Laparoscopy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology / Q000628:therapy*; D014062:Tongue Neoplasms / Q000473:pathology / Q000628:therapy*
keywords: Head and neck cancer, Percutaneous endoscopic gastrostomy, Pregnancy.