Feasibility and Benefit of Decompressive Percutaneous Endoscopic Gastrostomy (dPEG) in Advanced Cancer Patients with Malignant Bowel Obstruction

Overview

Journal Endosc Int Open

Specialty Gastroenterology

Date 2024 Nov 29

PMID 39610950

Authors

Julia Wanzl

Susanne Hofer

Tanja Schwamberger

Vidan Tadic

Anna Muzalyova

Irmtraut Hainsch-Muller

Christoph Aulmann

Helmut Messmann

Andreas Probst

Affiliations

Soon will be listed here.

Abstract

Bowel obstruction is a common complication in advanced cancer patients. Patients are restricted in quality of life (QOL) due to nausea, vomiting, or abdominal pain. Prospective data on the feasibility and benefit of decompressive percutaneous endoscopic gastrostomy (dPEG) are scarce. Patients suffering from symptomatic bowel obstruction due to advanced cancer were included prospectively in a single-center study when other treatments to eliminate the obstruction were impossible. Patients were given a questionnaire the day before dPEG (d-1) and, if the procedure was successful, the day after (d+1) and 14 days after the procedure (d14). Furthermore, lifetime after dPEG was assessed. 53 patients were included. dPEG was technically feasible in 34 of 53 (64.2%). Significant improvement could be shown for nausea and vomiting when comparing d-1 to d+1 (nausea ( = 0.002), vomiting ( < 0.001)) and when comparing d-1 to d14 ( = 0.021 and = 0.003, respectively). Comparing d+1 to d14, there was no further improvement. QOL improved significantly from 8.1 (mean) on d-1 to 5.9 (mean) on d+1 ( < 0.001). Median survival after successful dPEG was 27 days (range 2-353). dPEG is an effective method for quickly relieve symptoms of malignant bowel obstruction in advanced cancer patients. However, the technical success rate is limited and needs to be improved. Prospective studies comparing endoscopic and computed tomography-guided procedures are needed to avoid unsuccessful procedures in patients with advanced cancer and limited life expectancy.

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