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Stellenwert der perkutanen endoskopisch kontrollierten Gastrostomie bei Kopf-Hals-Tumorpatienten

The value of percutaneous endoscopic gastrostomy in ENT tumor patients

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Zusammenfassung

Viele Patienten mit fortgeschrittenen Kopf-Hals-Tumoren sind bereits bei der Erstdiagnose unzureichend ernährt und bedürfen einer supportiven Ernährungstherapie. Durch die Beseitigung der Mangelernährung wird die Rekonvaleszenz positiv beeinflusst, die Krankenhausverweildauer vermindert und die Prognose im Hinblick auf die Morbidität und Mortalität begünstigt. Bei der Ernährung über eine perkutane endoskopisch kontrollierte Gastrostomie (PEG) entfällt die soziale Stigmatisierung des Patienten durch die für jedermann sichtbar getragene Nasensonde. Die PEG kann problemlos durch die Kopf-Hals-Chirurgen durchgeführt werden bei Patienten, die prätherapeutisch an einem massiven tumorbedingten Gewichtsverlust leiden, bei zu erwartender Radiochemotherapie oder vor Tumoroperationen mit voraussichtlich notwendiger langwieriger Schluckrehabilitation. Über die PEG-Sonde können Medikamente zugeführt werden. Somit wird eine adäquate Schmerztherapie, die eine zentrale Bedeutung in der Betreuung des Kopf-Hals-Tumorpatienten hat, erheblich vereinfacht.

Abstract

Many patients with advanced head and neck cancer are already in a poor nutritional status and need supportive nutritional therapy at the time of initial diagnosis. Malnutrition is associated with delayed recovery, prolonged hospital stay and unfavorable prognosis. By using percutaneous endoscopic gastrostomy (PEG), the social stigmatization for the patient resulting from the conspicuous nasal feeding tube is avoided. The PEG can be easily implemented at the time of diagnosis by head and neck surgeons in patients suffering from massive tumor-associated weight loss, when definitive or adjuvant radiochemotherapy is anticipated, or prior to tumor surgery likely to be followed by prolonged significant dysphagia and protracted swallowing rehabilitation. Analgesics can be administered via the PEG tube, thus simplifying adequate pain management, which plays a central role in the care of head and neck cancer patients.

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  1. Hals-Nasen-Ohren-Klinik, Kopf- und Hals-Chirurgie, Universitätsklinikum Erlangen, Waldstraße 1, 91054, Erlangen, Deutschland

    K. Mantsopoulos, M. Koch, J. Zenk & H. Iro

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  1. K. Mantsopoulos
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  2. M. Koch
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  3. J. Zenk
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Correspondence to K. Mantsopoulos.

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Mantsopoulos, K., Koch, M., Zenk, J. et al. Stellenwert der perkutanen endoskopisch kontrollierten Gastrostomie bei Kopf-Hals-Tumorpatienten. HNO 58, 333–340 (2010). https://doi.org/10.1007/s00106-010-2095-9

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