TITLE

Palliative venting gastrostomy in malignant intestinal obstruction

AUTHOR(S)
Brooksbank, M A; Game, P A; Ashby, M A
PUB. DATE
October 2002
SOURCE
Palliative Medicine;Oct2002, Vol. 16 Issue 6, p520
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
This retrospective clinical study reports on the experience of palliative venting gastrostomy (PVG) in an integrated acute teaching hospital and hospice-based palliative care service over a seven-year period (1989–97). PVG was performed for 51 patients with refractory nausea and vomiting resulting from varying degrees and levels of persisting or intermittent malignant bowel obstruction. There were 32 females and 19 males; the mean age was 61 years (range 25–86 years). All patients had advanced and incurable cancer with intra-abdominal spread, originating from the following primary sites: colon and rectum (27), ovary (16), breast (2), pancreas (2), and other (4). The venting gastrostomy tube was inserted endoscopically by a railroading technique in 46 patients (using a 16- to 20-French Dobhoff PEG tube), at open laparotomy in four cases and under radiological (abdominal computerized tomography) control in one case. Endoscopic insertion was attempted and abandoned for technical reasons in a further two cases. The median survival of all 51 patients from the time of gastrostomy insertion was 17 days (range 1–190). In 47/51 (92%), the symptoms of nausea and vomiting were relieved by the procedure, and these patients experienced restoration of some level of oral soft food and fluid intake. Twenty patients were discharged home, and six died at home. In a small group of highly selected patients, for whom pharmacological measures failed to palliate the effects of malignant bowel obstruction, PVG was shown to be a safe and effective means of abolishing or substantially improving vomiting. Provided that the intervention is appropriate to the given clinical situation and acceptable to the patient, it should be considered.
ACCESSION #
8687622

 

Related Articles

  • Percutaneous endoscopic duodenostomy: the relief of obstruction in advanced gastric carcinoma. Dresner, S.M.; Wayman, J. // Palliative Medicine;1999, Vol. 13 Issue 2, p165 

    Describes a patient with linitis plastica and gastric stasis who was treated with a percutaneous endoscopic duodenostomy. Use of percutaneous endoscopic gastrostomy in palliative treatment of malignant gastrointestinal disease; Data of case presented.

  • Percutaneous Gastrostomy Feeding Tubes in End Stage Dementia: Don't "Just Do It". Chung, A. Maria // Canadian Association of Radiologists Journal;Aug2012 Supplement, pS5 

    The author reflects on the use of percutaneous gastronomy feeding tubes in patients with end stage dementia. She suggests that the tubes are commonly used in patients with several disorders including neurodegenerative diseases such as dementia. She argues that since there are several manpower...

  • Development of a pathway to facilitate gastrostomy insertion for patients with MND. Oliver, David; Bell, Jenny; Gallagher, Donal; Newton, Jenny; Rackham, Claire; Swannick, Jackie; Thompson, Sheila // International Journal of Palliative Nursing;Sep2007, Vol. 13 Issue 9, p426 

    A pathway has been developed using a multidisciplinary group from within specialist palliative care to ensure a comprehensive approach to the insertion of gastromy tubes for patients with motor neurone disease (MND) with swallowing difficulties. The pathway has ensured that there is a...

  • A patient with dementia and cancer: to feed via percutaneous endoscopic gastrostomy tube or not? Shah, Sanjay H. // Palliative Medicine;Nov2006, Vol. 20 Issue 7, p711 

    Despite the lack of clear benefits of feeding via gastrostomy tube in dementia patients, its use has been increasing. The views of health professionals, patients and their carers differ widely about the perceived benefits, which makes decision-making difficult and stressful. The palliative care...

  • Palliative care and end-of-life planning in Parkinson's disease. Walker, Richard // Journal of Neural Transmission;Apr2013, Vol. 120 Issue 4, p635 

    In Parkinson's disease (PD) typical 'palliative care' type symptoms, such as pain, nausea, weight loss and breathlessness can occur throughout the condition, but become more prevalent in later disease stages. Pain may be specifically related to PD, e.g. dystonic pain with wearing off, but is...

  • Normal Interstage Growth After the Norwood Operation Associated With Interstage Home Monitoring. Hehir, David; Rudd, Nancy; Slicker, Julie; Mussatto, Kathleen; Simpson, Pippa; Li, Shun-Hwa; Frommelt, Michele; Tweddell, James; Ghanayem, Nancy // Pediatric Cardiology;Dec2012, Vol. 33 Issue 8, p1315 

    After stage 1 palliation (S1P) with a Norwood operation, infants commonly experience growth failure during the initial interstage period. Growth failure during this high-risk period is associated with worse outcomes. This study evaluated the growth patterns of patients enrolled in the authors'...

  • Hospital and long-term outcome after percutaneous endoscopic gastrostomy. Smith, Brian; Perring, Paul; Engoren, Milo; Sferra, Joseph J. // Surgical Endoscopy;Jan2008, Vol. 22 Issue 1, p74 

    Percutaneous endoscopic gastrostomy (PEG) has become the preferred method of providing long-term enteral nutrition. While hospitalized patients frequently have PEG inserted to facilitate enteral nutrition, little is known about these patients. The objective of the study was to determine hospital...

  • Oral feeding difficulties and dilemmas. Gordon, Harriet // Dental Nursing;Sep2012, Vol. 8 Issue 9, p550 

    The article discusses oral feeding for the end of life patients which can be fraught with dilemmas for health professionals because patients cannot clearly give their views. A report from the Royal College of Physicians (RCP) and the British Society of Gastroenterology (BSG) may assist health...

  • Palliative venting percutaneous endoscopic gastrostomy tube is safe and effective in patients with malignant obstruction. Issaka, Rachel; Shapiro, David; Parikh, Neehar; Mulcahy, Mary; Komanduri, Srinadh; Martin, John; Keswani, Rajesh // Surgical Endoscopy;May2014, Vol. 28 Issue 5, p1668 

    Background and study aims: Obstructive symptoms are common in advanced malignancies. Venting percutaneous endoscopic gastrostomy (VPEG) tubes can be placed for palliation. The aim of this study was to determine the outcomes of VPEG placement in patients with advanced malignancy. Methods: We...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics