Prophylactic PEG placement in head and neck cancer：How many feeding tubes are unused （and unnecessary）

AIM：To determine the rate of use and non-use of prophylactic percutaneous endoscopic gastrostomy（PEG） tubes among patients with head and neck cancer（HNC） patients.METHODS：All patients with HNC undergoing PEG between January 01,2004 and June 30,2006 were identified.Patients（or their next-of-kin） were...

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Published in世界胃肠病学杂志：英文版 Vol. 17; no. 8; pp. 1004 - 1008
Main Author Mohammad F Madhoun Matt M Blankenship Derek M Blankenship Greg A Krempl William M Tierney
Format Journal Article
LanguageEnglish
Published 2011
Subjects
PEG
位置
头部
癌症患者
癌症治疗
预防性
颈部
食管
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Summary:AIM：To determine the rate of use and non-use of prophylactic percutaneous endoscopic gastrostomy（PEG） tubes among patients with head and neck cancer（HNC） patients.METHODS：All patients with HNC undergoing PEG between January 01,2004 and June 30,2006 were identified.Patients（or their next-of-kin） were surveyed by phone and all available medical records and cancer registry data were reviewed.Prophylactic PEG was def ined as placement in the absence of dysphagia and prior to radiation or chemoradiation.Each patient with a prophylactic PEG was assessed for cancer diagnosis,type of therapy,PEG use,and complications related to PEG.RESULTS：One hundred and three patients had PEG tubes placed for HNC.Thirty four patients（33%） could not be contacted for follow-up.Of the 23（22.3%） patients with prophylactic PEG tubes,11/23（47.8%） either never used the PEG or used it for less than 2 wk.No association with PEG use vs non-use was observed for cancer diagnosis,stage,or specific cancer treatment.Non-use or limited use was observed in 3/6（50%） treated with radiation alone vs 8/17（47.1%） treated with chemoradiation（P = 1.0）,and 3 of 10（30%） treated with surgery vs 8 of 13（62%） not treated with surgery（P = 0.21）.Minor complications were reported in 5/23（21.7%）.One（4.3%） major complication was reported.CONCLUSION：There is a high rate of unnecessary PEG placement when done prophylactically in patients with head and neck cancer.
Bibliography:14-1219/R
AIM：To determine the rate of use and non-use of prophylactic percutaneous endoscopic gastrostomy（PEG） tubes among patients with head and neck cancer（HNC） patients.METHODS：All patients with HNC undergoing PEG between January 01,2004 and June 30,2006 were identified.Patients（or their next-of-kin） were surveyed by phone and all available medical records and cancer registry data were reviewed.Prophylactic PEG was def ined as placement in the absence of dysphagia and prior to radiation or chemoradiation.Each patient with a prophylactic PEG was assessed for cancer diagnosis,type of therapy,PEG use,and complications related to PEG.RESULTS：One hundred and three patients had PEG tubes placed for HNC.Thirty four patients（33%） could not be contacted for follow-up.Of the 23（22.3%） patients with prophylactic PEG tubes,11/23（47.8%） either never used the PEG or used it for less than 2 wk.No association with PEG use vs non-use was observed for cancer diagnosis,stage,or specific cancer treatment.Non-use or limited use was observed in 3/6（50%） treated with radiation alone vs 8/17（47.1%） treated with chemoradiation（P = 1.0）,and 3 of 10（30%） treated with surgery vs 8 of 13（62%） not treated with surgery（P = 0.21）.Minor complications were reported in 5/23（21.7%）.One（4.3%） major complication was reported.CONCLUSION：There is a high rate of unnecessary PEG placement when done prophylactically in patients with head and neck cancer.
ISSN:1007-9327
2219-2840