Introduction: Patients with head and neck cancer (HNC) are at increased risk of malnutrition due to tumour location and side effects of treatment. This audit aims to review trends and reasons for gastrostomy tube insertion and nutritional outcomes in patients with HNC under the care of SIVUH.
Methods: Patients who had a gastrostomy tube inserted from January to December 2022 were included. Reason for insertion, treatment modality and nutritional indicators were recorded.
Results: Thirty-two new gastrostomy tubes were inserted. Eight were placed prophylactically and 24 were used immediately. Reasons for insertion were: 9 placed pre-treatment, 4 pre-surgery, 9 post-surgery, 5 for long-term post-treatment dysphagia and 5 for palliative reasons. 53.1% of patients lost weight from insertion to most recent dietetic review. 37.5% of patients gained weight. Overall weight loss was 1.1kg. Three patients did not use their gastrostomy (placed prophylactically). Seventeen patients remain on HEN.
Conclusion: This audit explores gastrostomy tube placement in HNC and its impact on nutrition. Although weight loss occurred in 53.1% of patients, this weight loss was not significant. Our previous audit in 2018 showed that 35 prophylactic tubes were placed in 1 year. This audit suggests a shift in trends of prophylactic gastrostomy tube placement. Decision making regarding gastrostomy tube insertion benefits from a multidisciplinary team approach. This information can be used in future developments for HNC treatment pathways.