Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Laryngoscope. 2023 Jan;133(1):109-115. doi: 10.1002/lary.30127. Epub 2022 Apr 2.
To examine outcomes and complications in patients receiving a percutaneous endoscopic gastrostomy (PEG) tube on the same day of head and neck cancer (HNC) surgery versus later in hospitalization.
The 2003-2014 Nationwide Inpatient Sample was queried for patients undergoing ablative HNC procedures who had a PEG tube placed. Cases were stratified by PEG tube timing into an early (on the same day as ablative procedure) and late (later in hospitalization) group. Demographics and outcomes were compared using univariate analysis and multivariate regression modeling.
A total of 4,068 cases were included, of which 2,206 (54.23%) underwent early PEG and 1,862 (45.77%) received a late PEG tube. Late PEG tube patients were more likely to have a diagnosis of malnutrition (18.0% vs. 15.3%, p = 0.018) or renal failure (4.7% vs. 3.0%, p = 0.006). On multivariate regression analysis, patients receiving late PEG tubes were more likely to experience aspiration pneumonia, acute pulmonary disease, infectious pneumonia, sepsis, hematoma, wound disruption, surgical site infection, and fistula formation (all p < 0.05). The mean length of stay and hospital charges in the late PEG group were significantly greater (17.1 vs. 12.6 days, p < 0.001) and ($159,993 vs. $125,705, p < 0.001), respectively.
Patients undergoing HNC surgery who received a PEG tube on the day of ablative surgery had lower complication rates, shorter length of stay, and decreased hospital costs compared to those who had a PEG tube placed later during hospitalization. Further research is needed to determine the causal relationships behind these findings.
3 Laryngoscope, 133:109-115, 2023.
研究头颈部癌症（HNC）手术当天和住院后期接受经皮内镜胃造口术（PEG）的患者的结局和并发症。
通过 2003 年至 2014 年全国住院患者样本，对接受消融性 HNC 手术并放置 PEG 管的患者进行了查询。根据 PEG 管放置时间，将病例分为早期（与消融性手术同日）和晚期（住院后期）两组。使用单变量分析和多变量回归模型比较人口统计学和结局。
共纳入 4068 例患者，其中 2206 例（54.23%）接受早期 PEG，1862 例（45.77%）接受晚期 PEG 管。晚期 PEG 管患者更有可能被诊断为营养不良（18.0% vs. 15.3%，p=0.018）或肾衰竭（4.7% vs. 3.0%，p=0.006）。多变量回归分析显示，接受晚期 PEG 管的患者更有可能出现吸入性肺炎、急性肺部疾病、感染性肺炎、败血症、血肿、伤口破裂、手术部位感染和瘘管形成（均 p<0.05）。晚期 PEG 组的平均住院时间和住院费用明显更长（17.1 天 vs. 12.6 天，p<0.001）和更高（159993 美元 vs. 125705 美元，p<0.001）。
与住院期间放置 PEG 管的患者相比，接受消融性手术当天放置 PEG 管的 HNC 手术患者的并发症发生率更低，住院时间更短，住院费用更低。需要进一步研究以确定这些发现背后的因果关系。
3 级。喉镜，133：109-115，2023。
