Palliative percutaneous endoscopic gastrostomy placementfor gastrointestinal cancer： Roles, goals, and complications

• 作者: Jitesh A Patel Matthew Mobily
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: PERCUTANEOUS endoscopic GASTROSTOMY tube PALLIATIVE care GASTROINTESTINAL cancer NUTRITIONAL supplementation GASTROINTESTINAL DECOMPRESSION
• 年，卷（期）: 2015,（4）
• 页码范围: 364-369
• 页数: 6页
• 分类号: R

摘要

Percutaneous endoscopic gastrostomy tube placementis an invaluable tool in clinical practice that has animportant role in the palliative care of patients withgastrointestinal cancer. While there is no extensivedata regarding the use of this procedure in patientswith gastrointestinal malignancy, inferences can bemade from the available information derived fromstudies of similar or mixed populations. Percutaneousendoscopic gastrostomy tubes can be used to provideenteral nutrition for terminal malignancies of the uppergastrointestinal tract as well as for decompressionof malignant obstructions. The rates of successfulplacement for cancer patients with either of theseindications are high, similar to those in mixed populations.There is no conclusive evidence that theprocedure will help patients reach nutritional goals forthose needing alimental supplementation. However, itis effective at relieving symptoms caused by malignantobstruction. A high American Society of Anesthesiologistphysical status score and an advanced tumor stagehave been shown to be independent predictors ofpoor outcomes following placement in cancer patients.This suggests the potential for similar outcomes inthe palliative care of patients with advanced stagegastrointestinal cancer who may be in relatively poorphysiologic condition. However, this potential should notpreclude its use in patients with terminal gastrointestinalcancer considering the high rate of successful tubeplacement, the possible benefits and the ultimate goalof comfort in palliative care.