Interdisciplinary Approach to Expedited Outpatient Gastrostomy Tube Placement in Head and Neck Cancer Patients: A Single Center Retrospective Study

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology Pub Date : 2024-09-01 DOI:10.1016/j.acra.2024.03.008

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引用次数: 0

Abstract

Rationale and Objective

Treatment for head and neck cancer (HNC) can lead to decreased oral intake which often requires gastrostomy tube (g-tube) placement to provide nutritional support. A multidisciplinary team (MDT) consisting of interventional radiology (IR), HNC oncology and surgery, nutrition, and speech language pathology departments implemented an expedited outpatient g-tube placement pathway to reduce hospital stays and associated costs, initiate feeds sooner, and improve communication between care teams. This single center study investigates differences in complications, time to procedure and costs savings with implementing this pathway.

Methods

142 patients with HNC who underwent elective image guided g-tube placement by IR from 2015 to 2022 were identified retrospectively. 52 patients underwent the traditional pathway, and 90 patients underwent the expedited pathway. Patient demographics, procedure characteristics, periprocedural costs and 90-day complication rates were collected and compared statistically.

Results

The 90-day complication rate was comparable between groups (traditional = 32.7%; expedited = 22.2%; p-value = 0.17). The expedited pathway decreased the time from consult to procedure by 11.1 days (95% CI 7.6 – 14.6; p < 0.001) and decreased charge per procedure by $2940 (95% CI $989–$4891; p < 0.001).

Conclusion

A MDT for the treatment of patients with HNC successfully provided enteral nutrition support faster, with fewer associated costs, and in a more patient centered approach than previously done at this institution.

查看原文本刊更多论文

头颈部癌症患者快速门诊胃管置入的跨学科方法：单中心回顾性研究

理由和目的：头颈癌（HNC）的治疗会导致口腔摄入量减少，通常需要放置胃造瘘管（g-tube）来提供营养支持。由介入放射学（IR）、HNC 肿瘤学和外科、营养学和语言病理学部门组成的多学科团队（MDT）实施了门诊病人快速胃管置入路径，以减少住院时间和相关费用、尽早开始喂养并改善护理团队之间的沟通。本项单中心研究调查了实施该路径在并发症、手术时间和成本节约方面的差异。方法：回顾性识别了2015年至2022年期间通过IR接受选择性图像引导g管置入术的142例HNC患者。52名患者接受了传统路径，90名患者接受了快速路径。收集了患者的人口统计学资料、手术特征、围手术期费用和90天并发症发生率，并进行了统计比较：结果：两组患者的 90 天并发症发生率相当（传统=32.7%；快速=22.2%；P 值=0.17）。加急路径将从就诊到手术的时间缩短了 11.1 天（95% CI 7.6 - 14.6；P 结论：MDT 是一种用于患者治疗的方法：治疗 HNC 患者的 MDT 成功地提供了肠内营养支持，与该机构以前的做法相比，速度更快、相关费用更低、更以患者为中心。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Radiology 医学-核医学

CiteScore

7.60

自引率

10.40%

发文量

432

审稿时长

18 days

期刊介绍： Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.