Percutaneous Gastrostomy Complications and the Management of Head and Neck Cancer

Abstract

Objective: 1) Understand the surgical site morbidity of percutaneous gastrostomy (PEG) in the head and neck cancer population. 2) Understand the implications of PEG morbidity on the therapy for head and neck cancer.

Method: A retrospective review was performed on patients with head and neck cancer undergoing PEG in a tertiary care center. Patients treated between 1998 and 2008 were eligible for inclusion. Demographic and oncologic data were recorded. Primary outcome measures were surgical complications and complication type arising from the gastrostomy itself.

Results: A total of 153 patients were identified with sufficient data available for review. A total of 61.6% of patients were male. Mean age was 58.1 years. Complications were observed in 28.1% of patients. The most common documented complication was leakage around the gastrostomy site (9.2%). Other observed complications included cellulitis of the abdominal wall (8.5%), abdominal wall abscess (1%), buried or extruded bumper (8%), and non-patent tubes (2.3%). Major complications were documented in 4 patients (2.6%) and included hemorrhage, perforated viscus, and peritonitis. No association of complications of any type with age, gender, tumor site, stage, or surgical service were observed.

Conclusion: Complications resulting from PEG in the head and neck cancer population are for the most part minor, self limited, and likely underreported. Major complications are infrequent but can be significant. Management and treatment implications with regards to head and neck cancer are discussed.