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

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

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