Completed Audit Cycle of RIG Complications in Head and Neck Cancer Patients

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Background Radiological Inserted Gastrostomy (RIG) is an alternative method of feeding head and neck cancer patients with potential associated complications following insertion.

Methods Data was collected from an interventional radiology database reviewing all head and neck cancer patients undergoing RIG insertion from 2007-2008. This was repeated following changes in suture removal timing from 2009-2010. The patient notes were retrospectively reviewed identifying complication demographics.

Results 63 RIG insertions were collected in the first cycle and 46 in the second cycle with no mortality. Major and minor complication rates were 7.9% and 63.4% in the first cycle versus 0% and 44.4% in the second cycle. Minor complications in surgical patients were significantly higher (P=0.02) than oncological cases in the first cycle. Minor complications were also noted to be significantly higher in the first (P<0.0001) and second (P=0.0009) cycle when compared with the gold standard of 22.1%. Average time of onset for major complications was 2+/-1 days (+/-SD) and for minor complications was 27+/-35 days. Tube dislodgement was the most common minor complication and improved following change in timing of suture removal, however there was an increase in infection rates. There was no significant difference in complication rates based on the grade of radiologist.

Conclusions We report no differences in major complications. Significantly higher rates of minor complications were noted in both cycles compared with the gold standard. The rates of tube dislodgement were reduced by leaving stay sutures in for longer at the expense of increased infection rates.

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Read 8183 times Last modified on Thursday, 14 May 2020 09:17

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