CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2022; 32(04): 471-478
DOI: 10.1055/s-0042-1750154
Original Article

Efficacy and Safety of Percutaneous Radiological Gastrostomy (PRG) as a Rescue Measure for Enteral Feeding in Patients with Advanced Head, Neck, and Upper Digestive Malignancies

Mukesh Kumar
1   Department of Radiology, Institute of Rotary Cancer Hospital (IRCH), All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
,
Anurag Chahal
1   Department of Radiology, Institute of Rotary Cancer Hospital (IRCH), All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
,
Sundeep Malla
1   Department of Radiology, Institute of Rotary Cancer Hospital (IRCH), All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
,
2   Department of Pain and Palliative Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
,
3   Department of Surgical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
,
Ahitagni Biswas
4   Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
,
5   Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
,
Raja Pramanik
5   Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
,
4   Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
,
Suman Bhaskar
4   Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
,
S.H. Chandrashekhara
1   Department of Radiology, Institute of Rotary Cancer Hospital (IRCH), All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
,
6   BRA-IRCH, Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
,
Sanjay Thulkar
1   Department of Radiology, Institute of Rotary Cancer Hospital (IRCH), All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India
› Author Affiliations

Abstract

Background Percutaneous radiologic gastrostomy is an established mode of enteral feeding for nutritional support for patients with dysphagia from upper digestive tract malignancy. Its role as a rescue measure in patients with advanced malignancy, presenting with absolute dysphagia and failure of nasogastric tube insertion has not been well established.

Purpose This study was performed to assess technical success and long-term outcomes of percutaneous radiologic gastrostomy (push type) for nutritional support for patients with absolute dysphagia as a last ditch nonsurgical rescue effort for enteral access.

Materials and Methods This was a prospective observational study of 31 patients who underwent push-type percutaneous radiologic gastrostomy over a period of 2 years (March 2017–March 2019). The study was a part of a larger trial approved by the institutional ethics committee. Patients were followed till the removal of tube, death, or 1 year, whichever was earlier. Gastrostomy tube-related problems and complications were documented. Descriptive summary statistics were employed to analyze the success rate and complications.

Results Thirty-one patients with mean age 56 years (26–78 years) including 18 males and 13 females with head and neck squamous cell cancer and esophageal cancer presenting with absolute dysphagia or significant dysphagia with failed nasogastric or endoscopic enteral access were included. Overall technical success was 93.5% (29/31), achieved in 26/31 patients with just fluoroscopy guidance and 3/5 patients with computed tomography guidance. One major (3.3%) and two minor (6.5%) complications were encountered. Five out of 29 gastrostomy tubes had to be exchanged, after a mean of 44 days (1–128 days) after insertion.

Conclusion Percutaneous radiologic gastrostomy is a safe and effective intervention even as a rescue measure in patients with absolute dysphagia from advanced upper digestive tract malignancies.



Publication History

Article published online:
31 October 2022

© 2022. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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