Innovative push percutaneous endoscopic gastrostomy by means of gastropexy and Foley catheter in a patient with advanced head and neck and esophageal cancer

Abstract

Enteral tube feeding plays a vital role in maintaining the quality of life of patients with cancer. Percutaneous endoscopic gastrostomy (PEG) with the push technique is a minimally invasive method that uses endoscopy to assist in the insertion of a feeding tube into the stomach. This method is preferred over pull method as it minimizes the risk of cancer spreading to the surrounding tissue of stroma, especially in patients with head and neck or esophageal cancer. However, it has some drawbacks, such as the possibility of complications related to the feeding tube and economic concerns. A surgical technique called push-PEG using thread the thread through trap and Alken metal dilator (5TAMeD) has been developed to provide a safe and simple method for oncologic patients in need of nutritional support. In a case study, a 59-year-old man diagnosed with malignant esophageal cancer underwent the push-PEG with 5TAMeD procedure and experienced a successful outcome. The patient's condition remained stable after the surgery, he was discharged from the hospital on the second day, and had no complications during the 4-week follow-up period. This case demonstrates the effectiveness, safety, and cost-effectiveness of the push-PEG with 5TAMeD technique for providing enteral nutrition support to advanced esophageal cancer patients.