The Indications Of PEG And The Progress In Prevention And Treatment Of The Fistula Metastasis After PEG In HNC Patients

Because of tumor compression,blockage,and anti-tumor treatment,the patients with head and neck cancer often have many side effects,such as dysphagia,loss of appetite,taste disappeared and so on,leading to malnutrition and weight loss,which requires nutritional support treatment.Percutaneous endoscopic gastrostomy is simple,less complications,It can effectively improve the patient's nutritional status and improve the treatment tolerance and quality of life.It has become the preferred method for long-term enteral nutrition.Patients with head and neck cancer in high-risk malnutrition undergoing prophylactic percutaneous endoscopic gastrostomy can reduce the incidence of serious adverse reactions to radiotherapy and chemotherapy,including mucositis and weight loss,avoid the interruption of radiotherapy and chemotherapy,reduce unplanned hospitalization rates and improve efficacy and survival.However,there is a rare complication of percutaneous endoscopic gastrostomy,which is the fistula metastasis.This complication is easy to be neglected due to its lower incidence.its pathogenesis is not clear,surgery,interstitial brachytherapy and radiofrequency ablation therapy may be effective.the use of preoperative radiotherapy and chemotherapy,overtubes,povidone iodine and a good fistula care can reduce the occurrence of this complication.This article will be on the the indications of percutaneous endoscopic gastrostomy,the pathogenesis,prevention,and prognosis of fistula metastasis to do a review.