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  Patronage of the Polish Society of Audiology and Phoniatrics

vol 6. no 3. September 2007  

 Original articles
The analysis of gastrostomy cases performed in patients with advanced-stage head and neck tumors
Magdalena Ziółkowska, Stanisław Bień

Introduction. Gastrostomy with palliative intention, performed at early stages of patient's malnutrition improves significantly the quality of life. The combination of chemo-and radiotherapy, as well as modern reconstructive procedures used to treat advanced head and neck tumors, often call for the gastrostomy as a planned step of radical treatment.
Aim. The aim of study was a presentation and analysis of 64 cases of gastrostomy performed as paliative or a part of radical treatment in patients with advanced head and neck tumors.
Material and methods. Between 2001 and 2006, 64 gastrostomy procedures were performed at the Dept. of Otolaryngology Head and Neck Surgery. The study group consisted mainly of males (89.1%) and laryngeal or laryngeal part of pharynx cancer was the most frequent diagnosis (45.5%). The data for the study was obtained from clinical records and follow-up.
Results. Dysphagia (82.8) was the main clinical indication for gastrostomy. Only in 17.2% of cases, gastrostomy was performed before the radical treatment or as an element of the treatment of post-surgery complications. The remaining gastrostomy procedures were performed as part of palliative treatment; in those cases, mean life expectancy was 52 days. The classic gastrostomy modo Kader or Witzel was performed in 86% of cases and percutaneous endoscopic gastrostomy (PEG) in 14% of cases. No severe complications due to gastrostomy were recorded. In 8 out of 11 cases the stoma was closed after the radical treatment had been completed.
Conclusions. In patients with advanced head and neck cancers one should attempt to extend the indications for gastrostomy as an element of curative treatment plan rather than implementing it as a solely palliative procedure.

keywords: rak głowy i szyi, niedożywienie, gastrostomia, PEG, head and neck cancer, malnutrition, gastrostomy, PEG

pages: from 147 to 150

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