Gastrostomy using a "Gastrofix" as an alternative for nasogastric tubes in ovarian cancer surgery

Objective: The aim of this study was to evaluate the use of a gastrostomy instead of a nasogastric tube following surgery for advanced ovarian cancer.

Design: This was a retrospective observational study.

Setting: The study was performed in a university teaching hospital.

Participants: Thirty-four women undergoing debulking surgery for ovarian carcinoma participated.

Methods: In order to increase patients' comfort during the first postoperative days we inserted for gastric decompression a transcutaneous instead of a transnasal tube following debulking surgery. Only patients with bowel involvement and/or extensive tumor load in the upper abdomen were included in the study. In this study we report on the use of a gastrostomy using a Cystofix drainage catheter, resulting in what we call a "Gastrofix." The Gastrofix was placed in 34 patients with ovarian cancer. In 32 (94%) patients an extraperitoneal hysterectomy and bilateral salpingo-oophorectomy was performed, in 16 (47%) a resection of the diaphragmatic peritoneum, in 14 (41%) patients a paraaortic lymphadenectomy, and in 12 (35%) patients part of the bowel was resected.

Results: Free oral liquid intake and poor fiber diet were started after 5.5 days (median, range from 3-8 days) and 8 days (median, range from 4-12 days), respectively. The catheter was clamped off after 5 days (median, range from 2-8 days) and removed after 7 days (median, range from 3-11 days). Of the 34 patients only 12 (35%) received antiemetics (median of 4 days, range from 1-7 days). In 1 patient (3%) pain at the insertion site was observed on the third and fourth postoperative days. In 3 patients (9%) some fluid leakage at the insertion site was noted. In 4 patients (12%) the catheter fell out prematurely on days 0, 4, 6, and 9, respectively. In none of the patients were infection or fistulas at the insertion site noted. In all patients there was a satisfactory drainage of gastric content.

Conclusion: After debulking surgery, the use of a Gastrofix resulted in an adequate gastrointestinal decompression without major complications. This technique may increase the comfort of the patient during the postoperative phase considerably.