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Percutaneous venting gastrostomy/gastrojejunostomy for malignant bowel obstruction: a qualitative study
  1. Rebecca Singh Curry1,
  2. Elizabeth Evans2,
  3. Anne-Marie Raftery3,
  4. Julia Hiscock4 and
  5. Marlise Poolman4
  1. 1The Supportive Care Team, The Christie NHS Foundation Trust, Manchester, UK
  2. 2Palliative Care Department, Betsi Cadwaladr University Health Board, Bangor, UK
  3. 3The Supportive Care Team, The Christie NHS Foundation Trust, Manchester, UK
  4. 4Bangor Institute for Health & Medical Research, Bangor University, Bangor, UK
  1. Correspondence to Dr Rebecca Singh Curry, Specialist Palliative Care Team, Stockport NHS Foundation Trust, Stockport SK2 7JE, UK; beckisingh{at}doctors.org.uk

Abstract

Objective Malignant bowel obstruction (MBO) is a complication of advanced malignancy and is associated with a short prognosis. MBO can infrequently be reversed by surgery or stenting. The focus of treatment is usually symptomatic management, of which percutaneous venting gastrostomy/gastrojejunostomy (PVG) is one consideration. There is little data considering the impact of PVG on quality of life; we therefore aimed to explore this.

Methods We identified patients with a PVG inserted for MBO and those who consented to participate were interviewed. The interviews were audio recorded, transcribed and analysed using Framework. Alongside patient interviews, a data collection tool was designed and used to record patient demographics and medical information, enabling us to contextualise individual patients’ experiences.

Results 11 patients were interviewed and 10 patients’ data were analysed (1 patient withdrew). No patients regretted having a PVG and many benefitted symptomatically and psychosocially. Challenges encountered included practical issues, pain and PVG tube complications.

Conclusions The analysis provided a detailed insight into the impact of PVG insertion and demonstrated that each patient’s experience is shaped by a complex interplay of individual factors, thereby highlighting the need to improve referral criteria and individualise patient selection. Other service improvements include enhancing information provision for patients and training for healthcare professionals, thus aiming to mitigate the challenges experienced. Our study is the first in-depth exploration of patients’ experiences of PVG at a tertiary cancer centre. Ensuring that the insights from this study are fed back to guide future service provision is critical in enhancing future patient experiences.

  • percutaneous venting gastrostomy
  • malignant bowel obstruction
  • patient experience
  • qualitative
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Footnotes

  • RSC and EE are joint first authors.

  • Contributors JH, MP and RSC were responsible for conception, design and the whole protocol and contributed to all components of the study. JH and MP oversaw the study. All the authors were responsible for the organisation and conduct of the study. RSC was responsible for acquisition of study data. EE was responsible for data analysis and all authors (except AMR) for interpretation of study data. EE and RSC drafted the manuscript. All authors critiqued the output, and 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.

  • Patient consent for publication Not required.

  • Ethics approval Our study was approved as a service evaluation project by the research and development department at the Christie Hospital (a tertiary cancer centre) (reference number CE15/1486).

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

  • Data availability statement Data are available upon reasonable request.

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