Role of percutaneous gastrostomy tubes in the postoperative care of patients with cancer of the oral cavity and oropharynx.

摘要

OBJECTIVE: The purpose of this study was to document the use and complications of gastrostomy tubes placed following surgery for oral cancer at our institution and to determine preoperative predictors of the procedure. METHOD: A retrospective chart review of 105 patients treated surgically for oral cancer between March 1990 and June 1995 at St. Joseph's Health Care Centre, London, Ontario was conducted. Twenty patients were studied with regard to timing, indication, and morbidity (n = 24) of the procedure. Regression analysis was performed regarding preoperative predictors of postoperative gastrostomy including tumour site and stage, and the percentage of tongue resected. Outcome measures included time from surgery to gastrostomy, length of postoperative hospital stay, time gastrostomy tube in situ, complications of gastrostomy, and the predicted risk of postoperative gastrostomy tube. RESULTS: The mean time to gastrostomy tube placement was 17.4 days, and the mean length of hospital stay in gastrostomy patients was 26.8 days. Gastrostomy was temporary in 55% of patients. No significant complications of percutaneous gastrostomy were encountered. Oropharyngeal tumour site and advanced T stage were predictive of the need for postoperative gastrostomy. CONCLUSIONS: In oral cavity and oropharyngeal cancer patients treated surgically, early postoperative percutaneous gastrostomy tube placement is indicated in those at high risk for significant postoperative dysphagia.