Taller A, Horvath E, Iliás L, Kótai Z, Simig M, Elö J, Harsányi L
Department of Gastroenterology, Uzsoki Teaching Hospital, Budapest, Hungary.
Gastrointest Endosc. 2001 Nov;54(5):633-6. doi: 10.1067/mge.2001.119221.
Patients with head and neck cancer (HNC) benefit from nutritional support by means of PEG tubes, but endoscopy may be impossible when there is partial or complete trismus and/or stenosis or occlusion of the upper aerodigestive tract.
PEG tubes were placed in 277 patients with HNC. Oral insertion of an endoscope into the esophagus was impossible in 27 patients. Transnasal endoscopy was performed (n = 4). In the cases of high-grade tumor obstruction, the endoscope was introduced into the esophagus through a straight laryngoscope (n = 9). When upper aerodigestive tract occlusion was present, endoscopy with PEG placement was successfully performed during surgery by means of the opened pharynx after tumor resection (n = 12).
In 25 of the 27 cases PEG tubes could be placed by using the above alternative techniques. There were no immediate complications, and no complications occurred within 30 days of PEG placement.
Transnasal, straight laryngoscopic, or intraoperative open endoscopy can improve the success rate for PEG tube placement in patients with HNC.
头颈部癌（HNC）患者可通过经皮内镜下胃造口术（PEG）管获得营养支持，但当存在部分或完全牙关紧闭和/或上消化道狭窄或闭塞时，内镜检查可能无法进行。
对277例HNC患者放置PEG管。27例患者无法经口将内镜插入食管。进行了经鼻内镜检查（n = 4）。在肿瘤高度梗阻的病例中，通过直接喉镜将内镜插入食管（n = 9）。当上消化道闭塞时，在肿瘤切除后通过开放的咽部在手术期间成功进行了内镜检查并放置PEG管（n = 12）。
27例中的25例可通过使用上述替代技术放置PEG管。无即刻并发症，PEG管放置后30天内也未发生并发症。
经鼻、直接喉镜或术中开放内镜检查可提高HNC患者PEG管放置的成功率。
