Michael M Maher MD, Abstract Co-Author: Nothing to Disclose

James Joseph Perumpillichira MD, Presenter: Nothing to Disclose

Mannudeep K. Kalra MD, Abstract Co-Author: Nothing to Disclose

Peter R Mueller MD, Abstract Co-Author: Nothing to Disclose

Peter Florin Hahn MD, Abstract Co-Author: Nothing to Disclose

Debra Ann Gervais MD, Abstract Co-Author: Nothing to Disclose

Catherine Saltalamachia RN, Abstract Co-Author: Nothing to Disclose

JoAnne Martino RN, Abstract Co-Author: Nothing to Disclose

Ronald Steven Arellano MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To describe an institutional experience with fluoroscopically guided percutaneous gastrostomy (PFG) and gastrojejunostomy (PFG-J) with gastropexy performed as an outpatient procedure in ambulatory patients with head and neck cancer.

Charts of patients who had PFG or PFG-J as outpatients from February 2003 to April 2004 were reviewed for patient demographics, indications for PFG, underlying cancer, type of PFG/ PFG-J device, technique, major complications (peritonitis, hemorrhage requiring transfusion, other complication requiring admission), minor complications (pain, superficial stoma/T-tack site infection, tube malfunction, tube falling out), duration to T-tack removal, interval to removal of tube, and complications following removal of tube.

Forty-one patients had 37 PFG and 4 PFG-J inserted with gastropexy using t-tacks. All tubes were inserted for hydration and nutrition during chemo radiation therapy. There were 30 males and 11 females with mean age of 56 (range 17-74) years. Interventional radiology nurse practitioners under physician supervision coordinated the outpatient care. Head and neck pathology included tongue (12), tonsil (7), pharyngeal (7), sinus (4), laryngeal (3), esophageal (2), nasal (2), mouth (1) and widespread (3) cancer. Mean follow-up was 27±2 weeks with five patients lost to follow-up after T-tack removal. There were no periprocedural or major complications. Three patients required admission unrelated to PFG, for sinus infection (1) chemotherapy complication (1) and pneumoperitoneum 45 days after tube insertion (1). Minor post procedure complications n=6 (15%) included: blocked tube (1), wound infection (3), diarrhea (1), and tube fell out (1). In 40 of 41 patients immediate post-procedure pain was controlled by acetaminophen and oxycodone combination. T-tacks were removed 13±1days post- procedure. The mean duration of G-tube was 17 ± 2 weeks (range 3-68 weeks). 18 patients had PFG removed without complication.

Outpatient PFG and PFG-J in ambulatory patients with head and neck cancer is feasible and safe resulting in no significant major complications.

Maher, M, Perumpillichira, J, Kalra, M, Mueller, P, Hahn, P, Gervais, D, Saltalamachia, C, Martino, J, Arellano, R, et al, , Feasibility of Fluoroscopically-directed Percutaneous Gastrostomy and Gastrojejunostomy in Outpatient Ambulatory Patients with Head and Neck Cancer: Experience in 41 Patients.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4411351.html