The prospective experience of a maxillofacial surgeon with the percutaneous endoscopic gastrostomy technique

C. Avery, S. Shenoy, S. Shetty, C. Siegmund, I. Mazhar, N. Taub

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Insertion of a percutaneous endoscopic gastrostomy (PEG) was attempted on 225 occasions, mainly for oral malignancy. Seventy-five percent (169/225) were inserted at the time of definitive surgery. There were significant incidental findings during 5% (11/225). The rate of successful insertion was 97% (219/225). The incidence of minor complications was 12% (26/225) and major complications 3% (7/225). There was no procedure-related mortality. The 30-day mortality rate, including those with terminal malignant disease, was 6% (14/225). An increased risk of death was associated with age of 65 years and over (P = 0.004). The median PEG duration was 337 (SE 31) days. Duration was significantly longer for stage T3-4 tumours (P = 0.028), N1 or greater neck disease (P = 0.034), following surgery with radiotherapy when compared to surgery alone (P < 0.001), particularly glossectomy (P = 0.038) and maxillectomy procedures (P = 0.003), after two separate surgical procedures and radiotherapy (P = 0.046) and following a composite bone resection (P = 0.031), or radiotherapy alone when compared to surgery alone (P = 0.003). There was no relationship to the type of flap used for reconstruction. Four patients have a long-term PEG. Only two patients did not use the PEG. The early insertion of a PEG in all patients undergoing free or pedicled flap reconstruction appears to be appropriate. The PEG procedure may be safely performed by an appropriately trained maxillofacial surgeon.

Original languageEnglish
Pages (from-to)140-148
Number of pages9
JournalInternational Journal of Oral and Maxillofacial Surgery
Volume37
Issue number2
DOIs
Publication statusPublished - 01-02-2008

    Fingerprint

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology

Cite this