PD507 - SAFETY OF GASTROSTOMY TUBES IN A HEAD AND NECK CANCER/MOTOR NEURON DISEASE COHORT. LEVERAGING ON ADVANTAGES OF THE PUSH-TECHNIQUE

PD507

SAFETY OF GASTROSTOMY TUBES IN A HEAD AND NECK CANCER/MOTOR NEURON DISEASE COHORT. LEVERAGING ON ADVANTAGES OF THE PUSH-TECHNIQUE

G. Morvil^1,*, K. K. J. Teh¹, K. W. Lim¹, R. Ravi¹, R. Asokkumar ¹, W. L. Liou¹, Y. Y. Tan¹, E. Salazar¹, J. N. C. Chong¹, M. C. C. Cheah¹

¹Gastroenterology, Singapore General Hospital, Singapore, Singapore

Rationale: Gastrostomy tubes are the cornerstone of long-term enteral feeding. While effective, procedure risks vary depending on patient comorbidities and underlying conditions. The “push” technique offers unique advantages over the “pull” method, such as using a 6mm slim gastroscope, allowing access in complex head and neck anatomy, and enabling low or no sedation in high-risk motor neuron disease patients. This study assesses the indications, safety, and outcomes of predominantly “push" gastrostomy cohort in a tertiary hospital.

Methods: A retrospective analysis of 221 patients who had gastrostomy tubes placed was performed. Data on patient demographics, procedural details, and clinical outcomes were collated.

Results: Mean patient age was 65.8 (±14.3) years, with 69.2% male. Primary indications included head and neck cancer (44.3%), motor neuron disease (28.5%), neurodegenerative diseases (7.2%), malignant bowel obstruction venting (6.8%), and stroke (6.3%). The push technique was used in 97.3% (n=215) of cases, with 64.7% (n=143) endoscopic and 35.3% (n=78) interventional radiology procedures.

Safety outcomes showed 3.6% 30-day mortality; seven deaths occurred in patients with malignancy, and one death occurred in a patient with Motor Neuron Disease. For complications, tube dislodgement occurred in one case, gastrostomy site bleeding in one case, and hypergranulation in one case. No aspiration pneumonia or site infections occurred within 30 days. Additionally, feeding commenced within 12 hours post-procedure in 78.2% and the length of stay for elective cases was 3.5 (±1.7) days.

Conclusion: The push technique demonstrates low complication rates and 30-day mortality driven by underlying disease progression rather than procedure-related issues, supporting its safety in head and neck cancer and motor neuron disease cohorts where pull techniques may be infeasible. 

Disclosure of Interest: G. Morvil: None declared, K. Teh: None declared, K. W. Lim: None declared, R. Ravi: None declared, R. Asokkumar : None declared, W. L. Liou: None declared, Y. Y. Tan: None declared, E. Salazar: None declared, J. Chong: None declared, M. Cheah Speakers Bureau of: Speaker for AVANOS