Complication Rates for Radiologically Inserted Gastrostomy in Head and Neck Cancer Inpatients

Abstract

Objective: Identify complications of Radiologically Inserted Gastrostomy (RIG) insertion and factors contributing to complication rates, including the grade of radiologist, forms of treatment, and time from RIG insertion to onset of complications.

Method: A retrospective audit was performed on head and neck cancer inpatients undergoing RIG insertion between 2007 and 2008. A case note review analyzed the type and timing of complications. A change in clinical practice was introduced by delaying RIG suture removal from 3 to 7 days. Complication rates were re-audited from 2009 to 2010.

Results: A total of 63 RIG insertions were performed on 56 inpatients (13 surgical and 50 oncological). Major and minor complication rates were 7.9% (n = 5) and 63.4% (n = 40), respectively. Minor complications in surgical patients were significantly higher (P = .02) than oncological cases (92.3% vs 56%). Average time onset for major complications was 2 ±1 days (±SD) and for minor complications was 27 ±35 days. There were no deaths. Tube dislodgement was the most common minor complication, and preliminary data from re-audit demonstrates improved rates following the change in timing of suture removal.

Conclusion: We report no differences in major complications. High rates of minor complications were noted. This may be due to the tube type or size utilized. Subgroup differences may be accounted for by timings in RIG placement. The rates of tube dislodgement were reduced by leaving stay sutures in for longer.