Table 2.
Review of the literature.
| Author, Year | Albrecht, 2017 [16] |
Zucchi, 2016 [17] |
DeEulis, 2015 [19] |
Spelsberg, 2013 [18] |
Brooksbank, 2002 [20] |
Sanchez, 1992 [13] |
|---|---|---|---|---|---|---|
| Patients, N | 102 | 158 | 6 | 101 | 51 | 22 ** |
| Indications (N of patients) |
feeding (57); decompression (45) |
decompression (158) | decompression (6) | feeding (87); decompression (14) |
decompression (51) |
feeding (7); decompression (15) |
| Ovarian cancer N (%) |
14 (31.1%) | 96 (60.7%) | 6 (100%) | 7 (6.9%) | 16 (31.3%) | 8 (36.3%) |
| The primary route of access in the study (N) | CT-guided with simultaneous endoscopy (98) | Endoscopic (PEG: 142 or PEJ: 14) |
Radiologic (2) Endoscopic (2) Surgical (1) |
CT-fluoroscopy with or without simultaneous endoscopy (101) |
Endoscopic (46) Surgical (4) |
CT-guided (22) |
| CT-guided decompressive gastrostomy, N |
45 | CT-PEG: 3 CT-PEJ: 1 |
2 | 14 | 1 | 15 |
| The main reasons for referring to CT-PG (N) |
inadequate transillumination (73), peritoneal carcinosis (20), obstructed passage (9). Upper GIS endoscopy was generally attempted in all patients |
stomach dislocation (2), gastric tubularization (1) |
n.a. | severe pharyngeal or oesophagal obstruction (30), recent pharyngeal surgery (20), peritoneal carcinosis (13), inadequate transillumination (6) |
not clearly defined: Inability to distend the stomach and transilluminate the abdominal wall (1), oesophageal obstruction (1) |
peritoneal tumour mass (6), large or low-lying liver (4), small gastric remnant (2), interposed bowel (n = 2), and prominent overlying ascites (n = 2). |
| Patients with ascites, N |
n.a. | n.a. | 3 | n.a. | n.a | 2 |
| Paracentesis, N | n.a. | n.a. | 3 | n.a. | n.a | n.a |
| Success rate (all) | 87.3% * f-PEG: 91.2% d-PEG: 82.2% |
89.8 % | 5 out of 6 patients |
88% § | 96% | 100% |
| Symptom relief (N) |
n.a. | 77.4 % experienced relief within 2 days; 64 % (16 of 25) exhibited improvement of QoL |
symptoms improved (6); tolerated clear liquids, pureed and soft foods (5); gastric tube removal (1) |
n.a. | 92% experienced symptom relief; resume oral soft food and fluid intake. |
n.a. |
| Complications (N) |
Dislocation (2); Minor complications (tube dysfunction, local bleeding, minimal leakage, local skin infection) in 13 of 102 patients |
Peristomal infection (14%), obstruction (8.4%), gastric leakage from ostomy (1.4%), gastric bleeding (2.1%), PEG displacement (2.1%), failure (1) |
No patients in this series experienced major or minor complications related to gastrostomy placement or function. |
No mortality; misplacement into the colon (1), local peritonitis (1), deep skin infection (1), dislodgement (17), peristomal leakage (7), superficial skin infection (6), tube obstruction (2) |
Pain at insertion site, haematoma in the abdominal wall (1), Excoriation of the skin (2), leakage of gastric contents (4), Tube blocking/dislodgement (4). |
No major complications; Replacement due to kink (2) at 45 and 53 days; catheter fracture (1) at 14 days. |
| Chemotherapy after gastrostomy |
n.a. | 9.8 % underwent salvage chemotherapy |
1 patient: 5th line cisplatin followed by 6th line topotecan |
n.a. | - | n.a. |
PEG: percutaneous endoscopic gastrostomy; PEJ: percutaneous endoscopic jejunostomy; * Reasons the procedures failed or were aborted included the following: stomach or proximal jejunum covered by a dilated colon or left lobe of the liver (n = 11); intramural gastric abscess–preoperative diagnosis with CT (n = 1); and vomiting and aspiration during the intervention (n = 1); ** Previous attempts for endoscopic G-Tube placement in 13 patients; fluoroscopic insertion failed in 17 patients.; § The reasons for not achieving success were the following: the stomach or proximal jejunum was covered by dilated colon or left lobe of the liver (n = 8), or the residual stomach was too small after a partial gastrectomy to permit the puncture (n = 4).