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Decompressive percutaneous endoscopic gastrostomy in advanced cancer patients with small-bowel obstruction is feasible and effective: a large prospective study
- Source :
- Supportive Care in Cancer.
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
Abstract
- Purpose The purpose of this study was to evaluate patientcentered outcomes of decompressive percutaneous endoscopic gastrostomy (dPEG) in patients with malignant bowel obstruction due to advanced gynecological and gastroenteric malignancies. Methods This is a prospective analysis of 158 consecutive patients with small-bowel obstruction from advanced gynecological and gastroenteric cancer who underwent PEG or percutaneous endoscopic jejunostomy (PEJ) positioning for decompressive purposes from 2002 to 2012. All of them had previous abdominal surgery and were unfit for any other surgical procedures. Symptom relief, procedural complications, and post dPEG palliation were assessed. Global Quality of Life (QoL) was evaluated in the last 2 years (25 consecutive patients) before and 7 days after dPEG placement using the Symptom Distress Scale (SDS). Results dPEG was successfully performed in 142 out of 158 patients (89.8 %). Failure of tube placement occurred in 16 patients (10.1 %). In 8/142 (5.6 %) patients, dPEG was guided by abdominal ultrasound. In 3/142 patients, dPEG was CT-guided. In 14 (9.8 %) patients, who had previously undergone total or subtotal gastrectomy, decompressive percutaneous endoscopic jejunostomy (dPEJ) was performed. In 1/14 patients, dPEJ was CT-guided. Out of 142 patients, 110 (77.4 %) experienced relief from nausea and vomiting 2d ays after PEG. Out of 142 patients, 116 (81.6 %) were discharged. The median postoperative hospital stay was 9 days (range 3–60). Peristomal infection (14 %) and intermittent obstruction (8.4 %) were the most frequent complications associated with PEG. Median survival time was 57 days (range 4–472) after PEG placement. Twenty-five patients had QoL properly evaluated with SDS score before and 7 days after dPEG. Sixteen patients (64 %) out of 25 exhibited an improvement of QoL (p
- Subjects :
- Adult
Male
medicine.medical_specialty
Nausea
medicine.medical_treatment
03 medical and health sciences
0302 clinical medicine
Quality of life
Percutaneous endoscopic gastrostomy
medicine
Humans
Prospective Studies
Aged
Gastrostomy
business.industry
Middle Aged
medicine.disease
Surgery
Bowel obstruction
Oncology
030220 oncology & carcinogenesis
Anesthesia
Jejunostomy
Quality of Life
Vomiting
Female
030211 gastroenterology & hepatology
medicine.symptom
business
Intestinal Obstruction
Abdominal surgery
Subjects
Details
- ISSN :
- 14337339 and 09414355
- Database :
- OpenAIRE
- Journal :
- Supportive Care in Cancer
- Accession number :
- edsair.doi.dedup.....fd7777789a1c8847979e75ced2da18f5