Pharyngostomy tubes for gastric conduit decompression

Natasha M. Rueth, Natasha Lee, Shawn S. Groth, Sarah C. Stranberg, Michael A. Maddaus, Jonathan D'Cunha, Rafael S. Andrade

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objective: This article illustrates our operative technique for pharyngostomy tube placement and describes our clinical experience with pharyngostomy use for gastric conduit decompression after esophagectomy. Methods: We retrospectively reviewed patients undergoing pharyngostomy tube placement for gastric conduit decompression after esophagectomy from January 2008 to August 2009. Patients were included if they had a pharyngostomy tube placed at esophagectomy (prophylactic placement) or as a means of decompression after postesophagectomy anastomotic leak (therapeutic placement). We collected operative and clinical data and performed a descriptive statistical analysis. Results: We placed 25 pharyngostomy tubes for gastric conduit decompression after esophagectomy. Eleven were placed prophylactically (44%); the remaining 14 were placed therapeutically (56%) after anastomotic leak. Prophylactic pharyngostomy tubes remained in place a median of 8 days (range 4-17 days), whereas therapeutic pharyngostomy tubes were left in place a median of 15 days (range 7-125 days). There were 4 infectious complications (16%) unrelated to length of pharyngostomy use: 2 cases of cellulitis (resolved with antibiotics, tube remaining in place) and 2 superficial abscesses after tube removal requiring bedside débridement. Seventy-two percent of patients underwent swallow evaluation; 22% of these patients had radiographic evidence of aspiration. Conclusions: Pharyngostomy tube placement for gastric conduit decompression after esophagectomy is simple, and tubes can stay in place for prolonged periods. Our experience suggests that pharyngostomy tubes are a safe alternative to nasogastric drainage.

Original languageEnglish (US)
Pages (from-to)373-376
Number of pages4
JournalJournal of Thoracic and Cardiovascular Surgery
Volume140
Issue number2
DOIs
StatePublished - 2010

Keywords

  • NGT
  • PT
  • nasogastric tube
  • pharyngostomy tube

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