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  • Venting percutaneous radiologic gastrostomy in malignant bowel obstruction: safety and effectiveness in a comprehensive cancer centre

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Venting percutaneous radiologic gastrostomy in malignant bowel obstruction: safety and effectiveness in a comprehensive cancer centre
  1. Inmaculada Peiró1,2,
  2. Jennifer Milla3,
  3. Lorena Arribas1,2,
  4. Laura Hurtós1,
  5. Ana Regina González-Tampán1,
  6. Marta Bellver1,
  7. Eduard Fort1,
  8. Kevin Molina-Mata4,
  9. Jonathan R Joudanin5,
  10. Joana Valcarcel5 and
  11. Jesús González-Barboteo2,3
  1. 1 Clinical Nutrition Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
  2. 2 Bellvitge Institute for Biomedical Research, Barcelona, Spain
  3. 3 Palliative Care Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
  4. 4 Medical Oncology Department, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
  5. 5 Department of Radiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
  1. Correspondence to Dr Inmaculada Peiró, Clinical Nutrition Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain; vpeiro{at}iconcologia.net

Abstract

Objective Approximately 20% of established malignant bowel obstruction (MBO) patients do not respond to pharmacological treatment. In these cases, venting percutaneous radiologic gastrostomy (VPRG) may be useful. Existing evidence is based on retrospective studies with methodological limitations. The purpose of this study is to describe safety and effectiveness for symptom control after VPRG placement in a prospective cohort of MBO patients.

Methods Complications of VPRG placement, symptom control, destination on discharge and survival were analysed.

Results Twenty-one patients were included, 13 (61.9%) of whom were women. Mean age was 62.7 years (36–85). Local pain (n=8, 38.1%) and peristomal leakage (n=4, 19%) were the most frequent minor complications. No major complications occurred. Nausea and vomiting were relieved in most patients (n=20, 95.2%) after VPRG, and small quantities of liquid diet were introduced to these patients. Median time to death after VPRG was 13 days (IQR 8.6–17.4). Thirteen patients (61.9%) were discharged, with seven of them (33.3%) returning home.

Conclusions When pharmacological treatment fails, the use of VPRG in MBO patients may be feasible, safe and effective.

  • Intestinal obstruction
  • Nausea and vomiting
  • Supportive care
  • Pain
  • Gastrointestinal (lower)
  • Genitourinary

https://doi.org/10.1136/spcare-2022-003895

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    Footnotes

    • Contributors All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by IP, JM, LA and JG-B. The first draft of the manuscript was written by IP and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.