Cervical Pharyngostomy Research Articles

Percutaneous Transesophageal Gastrostomy (PTEG) is a More Acceptable Technique than Cervical Pharyngostomy

Heart, Lung and Esophageal Surgery Institute; University of Pittsburgh Medical Center; Pittsburgh, Pennsylvania; E-mail: [email protected]

Percutaneous Transesophageal Gastrostomy (PTEG) is a More Acceptable Technique than Cervical Pharyngostomy

Ishizuka, Mitsuru MD; Nagata, Hitoshi MD; Takagi, Kazutoshi MD; Kubota, Keiichi MD Author Information

Cervical pharyngostomy: an alternative approach to enteral feeding

Surgical patients may be unable or unwilling to feed normally, owing to mechanical obstruction to ingestion because of nausea or anorexia or secondary to neurologic abnormality. Such patients may be in a malnourished state that compromises their chances of successful recovery. The Nasogastric tube (NGT) has been the standard method of postoperative alimentation in head and neck cancer patients. However, prolonged use of an NGT has been associated with many problems. Percutaneous endoscopic gastrotomy (PEG) tubes are generally easier to manage and more esthetically pleasing than NGTs. However, they are associated with their own set of shortcomings. Problems and complications with traditional NGT led us to evaluate feeding tubes placed through a cervical pharyngostomy. We present our experience with this technique in 15 patients in whom it was used for postoperative feeding after oropharyngeal cancer resection and reconstruction. The cervical pharyngostomy technique has proven to be a safe, reliable, cost-effective and convenient method for postoperative feeding.

Percutaneous cervical pharyngostomy: a traditional technique revisited

Enteral tube feeding is widely used in intensive care units, high dependency units and general wards. In some patients, an adequate intake is not maintained because patients cannot tolerate the tube. Insertion of an enteral feeding tube via a pharyngostomy is simple and potentially more easily tolerated. We describe our experience with three critically ill patients, using disposable vascular access equipment and a dilational technique. All three patients received markedly increased nutrition, but one patient suffered haemorrhagic complications.

A device to perform Percutaneous Cervical Pharyngostomy (PCP) for Enteral Nutrition

Percutaneous Cervical Pharyngostomy (PCP) is a technique of proven usefulness in Enteral Nutrition and has been used for over 20 years. The procedure has been modified to make it less traumatic and easier to perform. To further improve the technique we have developed a special device, with which it can be performed with minimum trauma under local anaesthesia, and with a smaller number of manoeuvres when compared with previous techniques. In addition, it gives rise to less occupation of the pharyngostomic passage by the nutritional tube (8 Fr.). We have successfully utilised this device on 37 patients, in whom the procedure took no more than 15 minutes. We had no technical complications. Based on our experience, we think that the use of this device makes the application of PCP easier in Enteral Nutrition.

Enteral feeding through percutaneous cervical pharyngostomy (PCP) : G.Gaggiotti, P.Orlandoni, R.Piazzai, G.Boccoli, S.Ambrosi, T.Bartolacci, V.Ciarrocca Department of Surgery and Nutrition I.N.R.C.A. - ANCONA - ITALY

Enteral feeding through percutaneous cervical pharyngostomy (PCP) : G.Gaggiotti, P.Orlandoni, R.Piazzai, G.Boccoli, S.Ambrosi, T.Bartolacci, V.Ciarrocca Department of Surgery and Nutrition I.N.R.C.A. - ANCONA - ITALY

Percutaneous cervical pharyngostomy: A comfortable and convenient alternative to protracted nasogastric intubation

For patients who require lengthy periods of enteral nutrition or gastrointestinal decompression, the use of a tube placed through a cervical pharyngostomy provides a convenient means of access to the upper gastrointestinal tract. The discomfort and complications of nasogastric intubation can be avoided, and the use of parenteral nutrition can be reduced in many cases where the gastrointestinal tract is functioning but the patient is unable to ingest food normally. The result of this technique in 42 patients over a 4 year period have been described herein. The patients found the method comfortable, cosmetically acceptable, and easily managed both in the hospital and at home. The technique of inserting the tube through the pyriform sinus is easy and safe to perform, and there have been no major complications in using the technique for periods up to 119 days. If accidentally displaced, the tube is easily reinserted through the neck without special equipment and with no discomfort. The method can provide a considerable improvement in the effectiveness of overall patient management. We suggest it could be more widely used in general surgical practice.

Intravenous hyperalimentation in head and neck tumour surgery: Indications and precautions

Major head and neck surgical procedures often result in temporary prevention of oral nutritional intake. Nasogastric or cervical pharyngostomy ( Royster et al., 1968 ) tubes are usually all that is required, but in certain circumstances intravenous hyperalimentation ( Dudrick et al., 1970 ; Dudrick and Rhoads, 1971) is the only way to achieve wound healing, positive nitrogen balance, and weight gain until oral feeding can be resumed ( Copeland et al., 1975 ). We have reviewed 25 head and neck surgery patients nourished in this way in order to define the indications for and the precautions to be taken with intravenous hyperalimentation in such patients.

Cervical pharyngostomy: A safe alternative for gastrointestinal decompression

Cervical pharyngostomy provides an alternative means of gastrointestinal decompression. It appears to have some advantages over nasogastric intubation for long-term use in seriously ill patients. The technic deserves a wider clinical trial.

Cervical pharyngostomy for tube feeding.

To the Editor.— In their response to the problem of long-term tube feeding of patients unable to swallow, Davis and Ziegler ( 214 :1127, 1970) admit that no ideal method exists. They list the disadvantages of longterm nasogastric intubation and feeding gastrostomy, but offer no alternative procedure. We have reported 1,2 the use of a simplified form of cervical pharyngostomy as a method which is more advantageous than the above techniques. This procedure involves placement of a feeding tube directly into the hypopharvnx at the pyriform sinus level through a simple stab wound in the side of the neck. It is performed with good tolerance when the patient is under local anesthesia. The distal end of the tube is then passed through the esophagus and into the stomach. The proximal end is secured by suture to the skin. At the end of the first week a sufficient tract has been formed

Cervical Esophagostomy

Percutaneous Cervical Pharyngostomy (PCP) is a technique of proven usefulness in Enteral Nutrition and has been used for over 20 years. The procedure has been modified to make it less traumatic and easier to perform. To further improve the technique we have developed a special device, with which it can be performed with minimum trauma under local anaesthesia, and with a smaller number of manoeuvres when compared with previous techniques. In addition, it gives rise to less occupation of the pharyngostomic passage by the nutritional tube (8 Fr.). We have successfully utilised this device on 37 patients, in whom the procedure took no more than 15 minutes. We had no technical complications. Based on our experience, we think that the use of this device makes the application of PCP easier in Enteral Nutrition.

Cervical pharyngostomy for feeding after maxillofacial surgery

A simplified method of tube alimentation by cervical pharyngostomy for use after resection for carcinoma of the neck and head is presented. The technic and a study of its use in a consecutive series of fifty patients are illustrated. This method is an improvement over nasogastric intubation and the gastrostomy for extraoral feeding.