PMID- 24366189
OWN - NLM
STAT- MEDLINE
DCOM- 20141125
LR  - 20211021
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 28
IP  - 5
DP  - 2014 May
TI  - Palliative venting percutaneous endoscopic gastrostomy tube is safe and effective 
      in patients with malignant obstruction.
PG  - 1668-73
LID - 10.1007/s00464-013-3368-7 [doi]
AB  - BACKGROUND AND STUDY AIMS: Obstructive symptoms are common in advanced 
      malignancies. Venting percutaneous endoscopic gastrostomy (VPEG) tubes can be 
      placed for palliation. The aim of this study was to determine the outcomes of 
      VPEG placement in patients with advanced malignancy. METHODS: We retrospectively 
      reviewed patients in whom a VPEG tube was attempted for a malignant indication 
      from 1998 to 2010 at a tertiary care center. Clinical information, procedure 
      details, and adverse events (AEs) were recorded. RESULTS: Ninety-six patients 
      meeting the inclusion criteria were identified. Colorectal (27 %), pancreas (18.8 
      %), and gynecologic (17.7 %) malignancies were most common. Overall, 46.9 % of 
      patients had ascites, with 35.6 % undergoing drainage prior to VPEG placement. 
      VPEG placement was successful in 89 patients (92.7 %), and relief of obstructive 
      symptoms was observed in 91.0 % of patients. Seven patients had refractory 
      symptoms despite functioning VPEG tube. Ten post-procedural AEs were noted in 
      nine patients, with one death. Infectious complications were more common in 
      patients with ascites (12.2 %) versus those without (0 %; p = 0.02). There was a 
      trend towards decreased infectious AEs when ascites was drained prior to VPEG 
      (14.8 vs. 7.1 %; p = 0.64) in our patient cohort. We observed a decreased 
      survival when AEs occurred (73 +/- 47.8 days) compared with when they did not occur 
      (141 +/- 367.8 days; p = 0.61). CONCLUSIONS: VPEG tubes can be safely placed in 
      patients with obstructive symptoms due to inoperable malignancy, with complete 
      relief in the majority of patients. Ascites was a risk factor for post-procedural 
      infectious AEs. Drainage of ascites prior to VPEG tube placement may decrease 
      this risk, although this requires further study.
FAU - Issaka, Rachel B
AU  - Issaka RB
AD  - Division of Internal Medicine, Feinberg School of Medicine, Northwestern 
      University, 251 E. Huron, Galter 3-150, Chicago, IL, 60611, USA, 
      rachel-issaka@fsm.northwestern.edu.
FAU - Shapiro, David M
AU  - Shapiro DM
FAU - Parikh, Neehar D
AU  - Parikh ND
FAU - Mulcahy, Mary F
AU  - Mulcahy MF
FAU - Komanduri, Srinadh
AU  - Komanduri S
FAU - Martin, John A
AU  - Martin JA
FAU - Keswani, Rajesh N
AU  - Keswani RN
LA  - eng
PT  - Journal Article
DEP - 20131224
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Endoscopy, Gastrointestinal/*methods
MH  - Enteral Nutrition/*instrumentation
MH  - Female
MH  - Gastrostomy/*methods
MH  - Humans
MH  - Intestinal Obstruction/etiology/*surgery
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/*complications
MH  - Palliative Care/*methods
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2013/12/25 06:00
MHDA- 2014/12/15 06:00
CRDT- 2013/12/25 06:00
PHST- 2013/06/14 00:00 [received]
PHST- 2013/12/01 00:00 [accepted]
PHST- 2013/12/25 06:00 [entrez]
PHST- 2013/12/25 06:00 [pubmed]
PHST- 2014/12/15 06:00 [medline]
AID - 10.1007/s00464-013-3368-7 [doi]
PST - ppublish
SO  - Surg Endosc. 2014 May;28(5):1668-73. doi: 10.1007/s00464-013-3368-7. Epub 2013 
      Dec 24.