Gastrostomies and clinical outcomes: a cohort of different enteral feeding techniques in advanced cancer palliative care
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Abstract
Background: The study aimed to assess complications after gastrostomy (GTT) performance using different techniques and the impact on the survival of patients with advanced cancer in exclusive palliative care.
Patients and methods: Retrospective study with patients using gastrostomies, hospitalized in the oncology palliative care unit, where complications of the procedure were evaluated according to the period of occurrence and case severity.
Results: A total of 47 patients participated, being 83% male. Surgical gastrostomy was performed in 17%, radio intervention in 51.1%, and endoscopy in 31.9%. At the time of GTT indication, functional capacity by Karnofsky Performance Status (KPS) was different between groups and 87.5% of patients eligible for surgery had KPS ≥ 60%. On the date scheduled for GTT via surgery, only 50% of patients had KPS ≥ 60% and at that time no difference in KPS was observed between the types of intervention. The most frequent complications were abdominal pain and extravasation of the diet. There was no difference in terms of complications regarding the type of technique chosen; however, individuals who submitted to radio intervention had a greater 30-day survival. C-reactive protein (CRP) > 10 mg/dL, Modified Glasgow Prognostic Score (mGPS) ≥ 1, and the presence of comorbidities were independent predictors of poorer survival.
Conclusions: These findings are consistent with those reported in the literature regarding complications, regardless of the technique selected. Strategies should be designed to reduce the interval between the indication and the performance of the procedure, to preserve the functionality of those patients with a recognized limited survival, and to obtain better benefits from this intervention.
Keywords: gastrostomycomplicationspalliative careenteral nutrition
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