CT-Guided Percutaneous Radiologic Gastrostomy for Patients with Head and Neck Cancer: A Retrospective Evaluation in 177 Patients.

Abstract

The purpose of this study was to assess the technical success rate and adverse events (AEs) associated with computed tomography (CT)-guided percutaneous gastrostomy for patients with head and neck cancer (HNC). This retrospective study included patients with HNC who had undergone CT-guided percutaneous gastrostomy between February 2007 and December 2013. Information regarding the patients' backgrounds, CT-guided percutaneous gastrostomy techniques, technical success rate, and AEs were obtained from the medical records. In all patients, the stomach was punctured under CT fluoroscopy with a Funada gastropexy device. During the study period, 177 patients underwent CT-guided percutaneous gastrostomy. The most common tumor location was the oral cavity, followed by the pharynx and maxilla. The indication for CT-guided percutaneous gastrostomy were tumor obstruction in 78 patients, postoperative dysphagia in 55 patients, radiation edema in 43 patients, and cerebral infarction in 1 patient. The technical success rate was 97.7%. The overall mean procedure time was 25.3min. Major AEs occurred in seven patients (4.0%), including bleeding (n=4), colonic injury (n=1), gastric tear (n=1), and aspiration pneumonia (n=1). Minor AEs occurred in 15 patients (8.5%), which included peristomal leakage (n=6), irritation (n=4), inadvertent removal (n=2), peristomal hemorrhage (n=1), peristomal infection (n=1), and wound granulation (n=1). The mean follow-up period was 111days (range 1-1106days). Our study suggests that CT-guided gastrostomy may be suitable in patients with HNC.