Details

Autor(en) / Beteiligte

• Stavrou, George
• Grosomanidis, Vassilios
• Sarafidou, Anastasia
• Tsiropoulos, Gavriil
• Triaridis, Stefanos
• Kotzampassi, Katerina

Titel

Percutaneous endoscopic gastrostomy through a cervical esophageal fistula. An alternative, much improved technique for patient safety

Ist Teil von

• American journal of otolaryngology, 2020-05, Vol.41 (3), p.102408-102408, Article 102408

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2020

Quelle

ScienceDirect

Beschreibungen/Notizen

• Percutaneous endoscopic gastrostomy [PEG] by the pull-technique is easy and safe to perform through the oral cavity. However, the presence of a cervical esophageal fistula, either due to tumor invasion or simply inflammation and tissue necrosis after previous intervention or radiotherapy, in the anterior cervical region is of crucial importance when passing the endoscope and the PEG catheter from the mouth downwards. We describe a modification of the standard peroral PEG, which is to insert the endoscope from the cervical esophageal opening instead of the oral cavity, and we support the use of this “stoma” as a way to protect it and avoid possible forceful dilatation/expansion when advancing the endoscope and the gastrostomy catheter through the mouth. The performance of PEG through the cervical esophageal opening was applied in 8 cases of esophageal fistula of different primary etiology but where the oro-pharyngeal passage was easily accessible. The procedure was technically successful in all patients, and no bleeding or tearing of the friable esophageal wall was evident. The use of the esophageal fistula at the anterior cervical region as a route for PEG insertion is a safe and practical alternative, highly to be recommended.