Sharma P, Berry S M, Wilson K, Neale H, Fink A S
Department of Otolaryngology, University of Cincinnati Medical Center, OH 45267.
Surg Endosc. 1994 Oct;8(10):1232-5. doi: 10.1007/BF00591059.
Percutaneous endoscopic gastrostomy (PEG) has become an important adjunct in the care of the head-and-neck cancer patient. When resection will likely affect swallowing, PEG can be performed just prior to cancer resection. However, it is unclear whether PEG should be the procedure of choice for establishing enteral access in head-and-neck cancer patients. In this report we describe a man with advanced oral squamous cell carcinoma who had a One-Step PEG button inserted immediately prior to his cancer resection. Six months later, the patient developed metastatic squamous-cell carcinoma at the PEG site. Although the mechanism of spread cannot be confirmed, direct seeding from passage through the cancer-filled oral cavity seems likely. Methods of establishing enteral access which avoid tumor-contaminated fields, such as use of an overtube during conventional PEG, open gastrostomy, or laparoscopic gastrostomy, may be more appropriate in head-and-neck cancer patients.
经皮内镜下胃造口术（PEG）已成为头颈癌患者护理中的一项重要辅助手段。当切除手术可能影响吞咽功能时，PEG可在癌症切除术前进行。然而，PEG是否应作为头颈癌患者建立肠内通路的首选方法尚不清楚。在本报告中，我们描述了一名患有晚期口腔鳞状细胞癌的男性患者，他在癌症切除术前立即插入了一步式PEG纽扣。六个月后，患者在PEG部位发生转移性鳞状细胞癌。尽管传播机制尚无法证实，但通过充满癌症的口腔通道直接播散似乎很有可能。在头颈癌患者中，采用避免肿瘤污染区域的肠内通路建立方法，如在传统PEG过程中使用外套管、开放式胃造口术或腹腔镜胃造口术，可能更为合适。
