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Gastrostomy in Patients with Previous Abdominal Surgery: A Comparative Study Between the Laparoscopy-Assisted Introducer Percutaneous Endoscopic Gastrostomy Versus Open Gastrostomy in Advanced Esophageal Cancer

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Abstract

Straightened nutritional status plays a vital role in the treatment outcome of advanced esophageal cancer. Both introducer percutaneous endoscopic gastrostomy (PEG) and open gastrostomy are safe options with avoidance risk of cancer cell seeding. The introducer PEG is an effective minimally invasive procedure with few complications, but the procedural method faces limitations for patients with a history of previous abdominal surgery. This study set out to compare the results of laparoscopy-assisted introducer PEG (LAIPEG) with open gastrostomy in advanced esophageal cancer patients with previous abdominal surgery. The advanced esophageal cancer patients who had previous abdominal surgery and indicated an enteral feeding tube between January 2014 and September 2019, were respectively analyzed. The open gastrostomy group was 35 patients, and the LAIPEG group was 18 patients. Operative duration, blood loss, postoperative pain score, and hospitalization time were significantly less in the LAIPEG group. Related procedural complications occurred only in the open gastrostomy group. Both groups are discharged from the hospital without readmission or 30-day mortality. Both procedures are safe options for advanced esophageal cancer patients with previous abdominal surgery for enteral feeding nutrition while minimizing the risk of cancer seeding. The LAIPEG demonstrated an effective minimally invasive procedure, which is safe with fewer complications. Previous surgery of the left supramesocolic area may be legitimate concerns before choosing introducer PEG for esophageal cancer with a history of prior surgery.

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Acknowledgements

Special thanks to Norman Mangnall for assistance in editing the English version of this manuscript.

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Authors and Affiliations

  1. Department of Surgery, Faculty of Medicine, Thammasat University (Rangsit Campus), 99/209, Moo 18 Paholyothin Road, Amphur Klongluang, 12120, Pathumthani, Thailand

    Prasit Mahawongkajit & Ajjana Techagumpuch

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  1. Prasit Mahawongkajit
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  2. Ajjana Techagumpuch
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Correspondence to Prasit Mahawongkajit.

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Prasit Mahawongkajit, Ajjana Techagumpuch declare no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study passed the ethical research process from Human Ethics Committee of Thammasat University (Faculty of Medicine) with reference number; MTU-EC-SU-0-165/62. Informed consent: Informed consent was obtained from all individual participants included in the study.

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Mahawongkajit, P., Techagumpuch, A. Gastrostomy in Patients with Previous Abdominal Surgery: A Comparative Study Between the Laparoscopy-Assisted Introducer Percutaneous Endoscopic Gastrostomy Versus Open Gastrostomy in Advanced Esophageal Cancer. Dysphagia 36, 67–72 (2021). https://doi.org/10.1007/s00455-020-10110-5

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  • DOI: https://doi.org/10.1007/s00455-020-10110-5

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