Cargando…

Efficacy and Safety of Percutaneous Radiological Gastrostomy (PRG) as a Rescue Measure for Enteral Feeding in Patients with Advanced Head, Neck, and Upper Digestive Malignancies

Background  Percutaneous radiologic gastrostomy is an established mode of enteral feeding for nutritional support for patients with dysphagia from upper digestive tract malignancy. Its role as a rescue measure in patients with advanced malignancy, presenting with absolute dysphagia and failure of na...

Descripción completa

Detalles Bibliográficos
Autores principales: Kumar, Mukesh, Chahal, Anurag, Malla, Sundeep, Bharti, Sachidanand G., Kumar, Sunil, Biswas, Ahitagni, Sahoo, Ranjit, Pramanik, Raja, Pathy, Sushmita, Bhaskar, Suman, Chandrashekhara, S.H., Sreenivas, V., Thulkar, Sanjay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical and Scientific Publishers Pvt. Ltd. 2022
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9705132/
https://www.ncbi.nlm.nih.gov/pubmed/36451943
http://dx.doi.org/10.1055/s-0042-1750154
_version_ 1784840209003708416
author Kumar, Mukesh
Chahal, Anurag
Malla, Sundeep
Bharti, Sachidanand G.
Kumar, Sunil
Biswas, Ahitagni
Sahoo, Ranjit
Pramanik, Raja
Pathy, Sushmita
Bhaskar, Suman
Chandrashekhara, S.H.
Sreenivas, V.
Thulkar, Sanjay
author_facet Kumar, Mukesh
Chahal, Anurag
Malla, Sundeep
Bharti, Sachidanand G.
Kumar, Sunil
Biswas, Ahitagni
Sahoo, Ranjit
Pramanik, Raja
Pathy, Sushmita
Bhaskar, Suman
Chandrashekhara, S.H.
Sreenivas, V.
Thulkar, Sanjay
author_sort Kumar, Mukesh
collection PubMed
description Background  Percutaneous radiologic gastrostomy is an established mode of enteral feeding for nutritional support for patients with dysphagia from upper digestive tract malignancy. Its role as a rescue measure in patients with advanced malignancy, presenting with absolute dysphagia and failure of nasogastric tube insertion has not been well established. Purpose  This study was performed to assess technical success and long-term outcomes of percutaneous radiologic gastrostomy (push type) for nutritional support for patients with absolute dysphagia as a last ditch nonsurgical rescue effort for enteral access. Materials and Methods  This was a prospective observational study of 31 patients who underwent push-type percutaneous radiologic gastrostomy over a period of 2 years (March 2017–March 2019). The study was a part of a larger trial approved by the institutional ethics committee. Patients were followed till the removal of tube, death, or 1 year, whichever was earlier. Gastrostomy tube-related problems and complications were documented. Descriptive summary statistics were employed to analyze the success rate and complications. Results  Thirty-one patients with mean age 56 years (26–78 years) including 18 males and 13 females with head and neck squamous cell cancer and esophageal cancer presenting with absolute dysphagia or significant dysphagia with failed nasogastric or endoscopic enteral access were included. Overall technical success was 93.5% (29/31), achieved in 26/31 patients with just fluoroscopy guidance and 3/5 patients with computed tomography guidance. One major (3.3%) and two minor (6.5%) complications were encountered. Five out of 29 gastrostomy tubes had to be exchanged, after a mean of 44 days (1–128 days) after insertion. Conclusion  Percutaneous radiologic gastrostomy is a safe and effective intervention even as a rescue measure in patients with absolute dysphagia from advanced upper digestive tract malignancies.
format Online
Article
Text
id pubmed-9705132
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format MEDLINE/PubMed
spelling pubmed-97051322022-11-29 Efficacy and Safety of Percutaneous Radiological Gastrostomy (PRG) as a Rescue Measure for Enteral Feeding in Patients with Advanced Head, Neck, and Upper Digestive Malignancies Kumar, Mukesh Chahal, Anurag Malla, Sundeep Bharti, Sachidanand G. Kumar, Sunil Biswas, Ahitagni Sahoo, Ranjit Pramanik, Raja Pathy, Sushmita Bhaskar, Suman Chandrashekhara, S.H. Sreenivas, V. Thulkar, Sanjay Indian J Radiol Imaging Background  Percutaneous radiologic gastrostomy is an established mode of enteral feeding for nutritional support for patients with dysphagia from upper digestive tract malignancy. Its role as a rescue measure in patients with advanced malignancy, presenting with absolute dysphagia and failure of nasogastric tube insertion has not been well established. Purpose  This study was performed to assess technical success and long-term outcomes of percutaneous radiologic gastrostomy (push type) for nutritional support for patients with absolute dysphagia as a last ditch nonsurgical rescue effort for enteral access. Materials and Methods  This was a prospective observational study of 31 patients who underwent push-type percutaneous radiologic gastrostomy over a period of 2 years (March 2017–March 2019). The study was a part of a larger trial approved by the institutional ethics committee. Patients were followed till the removal of tube, death, or 1 year, whichever was earlier. Gastrostomy tube-related problems and complications were documented. Descriptive summary statistics were employed to analyze the success rate and complications. Results  Thirty-one patients with mean age 56 years (26–78 years) including 18 males and 13 females with head and neck squamous cell cancer and esophageal cancer presenting with absolute dysphagia or significant dysphagia with failed nasogastric or endoscopic enteral access were included. Overall technical success was 93.5% (29/31), achieved in 26/31 patients with just fluoroscopy guidance and 3/5 patients with computed tomography guidance. One major (3.3%) and two minor (6.5%) complications were encountered. Five out of 29 gastrostomy tubes had to be exchanged, after a mean of 44 days (1–128 days) after insertion. Conclusion  Percutaneous radiologic gastrostomy is a safe and effective intervention even as a rescue measure in patients with absolute dysphagia from advanced upper digestive tract malignancies. Thieme Medical and Scientific Publishers Pvt. Ltd. 2022-10-31 /pmc/articles/PMC9705132/ /pubmed/36451943 http://dx.doi.org/10.1055/s-0042-1750154 Text en Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Kumar, Mukesh
Chahal, Anurag
Malla, Sundeep
Bharti, Sachidanand G.
Kumar, Sunil
Biswas, Ahitagni
Sahoo, Ranjit
Pramanik, Raja
Pathy, Sushmita
Bhaskar, Suman
Chandrashekhara, S.H.
Sreenivas, V.
Thulkar, Sanjay
Efficacy and Safety of Percutaneous Radiological Gastrostomy (PRG) as a Rescue Measure for Enteral Feeding in Patients with Advanced Head, Neck, and Upper Digestive Malignancies
title Efficacy and Safety of Percutaneous Radiological Gastrostomy (PRG) as a Rescue Measure for Enteral Feeding in Patients with Advanced Head, Neck, and Upper Digestive Malignancies
title_full Efficacy and Safety of Percutaneous Radiological Gastrostomy (PRG) as a Rescue Measure for Enteral Feeding in Patients with Advanced Head, Neck, and Upper Digestive Malignancies
title_fullStr Efficacy and Safety of Percutaneous Radiological Gastrostomy (PRG) as a Rescue Measure for Enteral Feeding in Patients with Advanced Head, Neck, and Upper Digestive Malignancies
title_full_unstemmed Efficacy and Safety of Percutaneous Radiological Gastrostomy (PRG) as a Rescue Measure for Enteral Feeding in Patients with Advanced Head, Neck, and Upper Digestive Malignancies
title_short Efficacy and Safety of Percutaneous Radiological Gastrostomy (PRG) as a Rescue Measure for Enteral Feeding in Patients with Advanced Head, Neck, and Upper Digestive Malignancies
title_sort efficacy and safety of percutaneous radiological gastrostomy (prg) as a rescue measure for enteral feeding in patients with advanced head, neck, and upper digestive malignancies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9705132/
https://www.ncbi.nlm.nih.gov/pubmed/36451943
http://dx.doi.org/10.1055/s-0042-1750154
work_keys_str_mv AT kumarmukesh efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies
AT chahalanurag efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies
AT mallasundeep efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies
AT bhartisachidanandg efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies
AT kumarsunil efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies
AT biswasahitagni efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies
AT sahooranjit efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies
AT pramanikraja efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies
AT pathysushmita efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies
AT bhaskarsuman efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies
AT chandrashekharash efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies
AT sreenivasv efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies
AT thulkarsanjay efficacyandsafetyofpercutaneousradiologicalgastrostomyprgasarescuemeasureforenteralfeedinginpatientswithadvancedheadneckandupperdigestivemalignancies