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Peritonitis related to percutaneous endoscopic gastrostomy using the direct method for cancer patients

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Abstract

Background

Percutaneous endoscopic gastrostomy (PEG) using the direct method is generally indicated for cancer patients. However, there are little available data about peritonitis related to this method. The aim of this retrospective analysis was to assess peritonitis related to PEG using the direct method in patients with cancer.

Methods

We assessed the prevalence of peritonitis and the relationship between peritonitis and patients’ backgrounds, as well as the clinical course after peritonitis.

Results

Between December 2008 and December 2011, peritonitis was found in 9 (2.1 %) of 421 patients. Of the 9 patients with peritonitis, 4 had received PEG prior to chemoradiotherapy. Emergency surgical drainage was required in 1 patient, and the remaining 8 recovered with conservative treatment. Peritonitis occurred within 8 days of PEG for 8 of the 9 patients and occurred within 2 days of suture removal for 4 of the 9 patients.

Conclusion

Peritonitis related to PEG using the direct method was less frequent for cancer patients. Peritonitis tended to occur within a few days after removal of securing suture and in patients with palliative stage.

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References

  1. Gauderer MW, Ponsky JL, Izant RJ Jr (1980) Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg 15(6):872–875

    Article  CAS  PubMed  Google Scholar 

  2. van Bokhorst-de van der Schueren MA, van Leeuwen PA, Sauerwein HP, Kuik DJ, Snow GB, Quak JJ (1997) Assessment of malnutrition parameters in head and neck cancer and their relation to postoperative complications. Head Neck 19(5):419–425

    Article  CAS  PubMed  Google Scholar 

  3. Bassett MR, Dobie RA (1983) Patterns of nutritional deficiency in head and neck cancer. Otolaryngol Head Neck Surg 91(2):119–125

    CAS  PubMed  Google Scholar 

  4. Beer KT, Krause KB, Zuercher T, Stanga Z (2005) Early percutaneous endoscopic gastrostomy insertion maintains nutritional state in patients with aerodigestive tract cancer. Nutr Cancer 52(1):29–34

    Article  PubMed  Google Scholar 

  5. Locher JL, Bonner JA, Carroll WR, Caudell JJ, Keith JN, Kilgore ML, Ritchie CS, Roth DL, Tajeu GS, Allison JJ (2011) Prophylactic percutaneous endoscopic gastrostomy tube placement in treatment of head and neck cancer: a comprehensive review and call for evidence-based medicine. JPEN J Parenter Enteral Nutr 35(3):365–374

    Article  PubMed  Google Scholar 

  6. Inoue N (2005) A new PEG technique “Direct Method” and fistula infection. Home Health Care Endosc Ther Qual Life 9:79–83

    Google Scholar 

  7. Foster JM, Filocamo P, Nava H, Schiff M, Hicks W, Rigual N, Smith J, Loree T, Gibbs JF (2007) The introducer technique is the optimal method for placing percutaneous endoscopic gastrostomy tubes in head and neck cancer patients. Surg Endosc 21(6):897–901

    Article  PubMed  Google Scholar 

  8. Cruz I, Mamel JJ, Brady PG, Cass-Garcia M (2005) Incidence of abdominal wall metastasis complicating PEG tube placement in untreated head and neck cancer. Gastrointest Endosc 62(5):708–711 quiz 752, 753

    Article  PubMed  Google Scholar 

  9. Hiki N, Maetani I, Suzuki Y, Washizawa N, Fukuda T, Yamaguchi T (2008) Reduced risk of peristomal infection of direct percutaneous endoscopic gastrostomy in cancer patients: comparison with the pull percutaneous endoscopic gastrostomy procedure. J Am Coll Surg 207(5):737–744

    Article  PubMed  Google Scholar 

  10. Horiuchi A, Nakayama Y, Tanaka N, Fujii H, Kajiyama M (2008) Prospective randomized trial comparing the direct method using a 24 Fr bumper-button-type device with the pull method for percutaneous endoscopic gastrostomy. Endoscopy 40(9):722–726

    Article  CAS  PubMed  Google Scholar 

  11. Yagishita A, Kakushima N, Tanaka M, Takizawa K, Yamaguchi Y, Matsubayashi H, Ono H (2012) Percutaneous endoscopic gastrostomy using the direct method for aerodigestive cancer patients. Eur J Gastroenterol Hepatol 24(1):77–81

    Article  PubMed  Google Scholar 

  12. Faias S, Buck G, Delegge M (2006) Peritonitis after percutaneous endoscopic gastrostomy and jejunostomy: where there is smoke, there may not be fire. Endoscopy 38(7):745–748

    Article  CAS  PubMed  Google Scholar 

  13. Richards DM, Tanikella R, Arora G, Guha S, Dekovich AA (2012) Percutaneous endoscopic gastrostomy in cancer patients: predictors of 30-day complications, 30-day mortality, and overall mortality. Dig Dis Sci 58:768–776

    Article  PubMed  Google Scholar 

  14. Richter-Schrag HJ, Richter S, Ruthmann O, Olschewski M, Hopt UT, Fischer A (2011) Risk factors and complications following percutaneous endoscopic gastrostomy: a case series of 1041 patients. Can J Gastroenterol 25(4):201–206

    PubMed Central  PubMed  Google Scholar 

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Disclosures

Shozo Osera, Tomonori Yano, Tomoyuki Odagaki, Yasuhiro Oono, Hiroaki Ikematsu, Atsushi Ohtsu, and Kazuhiro Kaneko have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Endoscopy Division, Department of Gastroenterology and GI Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan

    Shozo Osera, Tomonori Yano, Tomoyuki Odagaki, Yasuhiro Oono, Hiroaki Ikematsu & Kazuhiro Kaneko

  2. Juntendo University Graduate School of Medicine, Tokyo, Japan

    Shozo Osera & Atsushi Ohtsu

Authors
  1. Shozo Osera
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  2. Tomonori Yano
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  3. Tomoyuki Odagaki
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  4. Yasuhiro Oono
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  5. Hiroaki Ikematsu
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  6. Atsushi Ohtsu
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  7. Kazuhiro Kaneko
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Corresponding author

Correspondence to Tomonori Yano.

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Osera, S., Yano, T., Odagaki, T. et al. Peritonitis related to percutaneous endoscopic gastrostomy using the direct method for cancer patients. Surg Endosc 29, 2941–2946 (2015). https://doi.org/10.1007/s00464-014-4026-4

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  • DOI: https://doi.org/10.1007/s00464-014-4026-4

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