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Complications following gastrostomy tube insertion in patients with head and neck cancer
Clinical Otolaryngology, 04/09/09

Grant DG et al. - In a study to measure morbidity and mortality rates following insertion of gastrostomy tubes in head and neck cancer (HNC) pts and to determine evidence for any relationship between gastrostomy insertion technique and complication rates, it was shown that procedure-related mortality rates following gastrostomy in HNC pts are higher than those in mixed pt populations. Major complication rates following radiologically inserted gastrostomy (RIG) in HNC pts are greater than those following percutaneous endoscopic gastrostomy (PEG). Major complications following PEG in pts with HNC appear no worse than in mixed pathology groups. RIG is associated with increased morbidity and mortality in pts who are ineligible for PEG.

Methods

172 pts with HNC underwent gastrostomy tube insertion between 2004 and 2005.
PEG was performed in 121 pts; 51 pts had RIG.
27 studies reporting outcomes following 2353 gastrostomy procedures for HNC.
Main outcome measures included post-procedure mortality, major and minor complications.

Results

Mortality rates were 1.0% (1/121) for PEG and 3.9% (2/51) for RIG.
Overall major complication rates following PEG and RIG were 3.3% (4/121) and 15.6% (9/51) respectively.
In a systematic review and meta-analysis of 2379 HNC pts, fatality rates of 2.2% were observed following PEG and 1.8% following RIG.
Major complication rates following PEG were 7.4% and 8.9% after RIG.

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