Do we have too many instruments on our surgical trays? A prospective audit of septoplasty trays in a DGH

Abstract

Study design: Retrospective review. Aim: The objective of this pilot study is to evaluate the safety of radiologically inserted gastrostomy (RIG) for head and neck cancer patients in a district general hospital (DGH) setting. Background:Gastrostomy feeding is an effective method of long term feeding in patients with head and neck cancer. There are currently no guidelines for the most appropriate gastrostomy or optimal timing of placement. An increasing number of tubes are being placed prophylactically following multidisciplinary Head & Neck team decision. Fife head and neck cancer patients undergo surgery, chemotherapy and radiotherapy at tertiary centres in Lothian. Prophylactic RIG placement is carried out at a secondary district general hospital where the specialist service is available. Method: A retrospective review was performed of 83 head and neck cancer patients undergoing RIG insertion from January 2011 to December 2014. Results: No patients experienced any major complications. One patient had acute disproportionate pain post operatively requiring prolonged analgesia. Four patients had peritubal cellulitis treated with local wound hygiene measures. Conclusion: RIG insertion is a safe method in head and neck cancer patients in a DGH setting. Additional advantages include ease of scheduling of these patients within a local treatment centre.