P1.090. Innovative Push Percutaneous Endoscopic Gastrostomy Using Thread-Through-Trap and Alken Dilator in Advanced Esophageal and Head and Neck Cancer

Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – technique Background Percutaneous endoscopic gastrostomy (PEG) using the push technique is a minimally invasive alternative to surgical gastrostomy that reduces procedure-related morbidity and the risk of tumor seeding. This approach is particularly beneficial in patients with advanced esophageal and head and neck cancers. Methods An innovative push-PEG technique, termed Thread The Thread Though Trap and Alken Metal Dilator (5TAMeD) technique, was developed for patients with advanced esophageal cancer. The procedure employs a simple surgical method using an Alken metal dilator to establish gastrostomy access. A Foley catheter was used as the gastrostomy tube because of its wide availability and lower cost compared with commercial PEG kits. Patient characteristics, procedural details, postoperative outcomes, and pain scores were retrospectively reviewed for cases performed between January 2024 and December 2025. All procedures were conducted using the push-PEG approach. Results A total of 23 patients underwent push PEG using the 5TAMeD technique for enteral nutritional support. Technical success was achieved in all cases. The mean procedural time was 30.74 ± 8.04 minutes. The postoperative pain score, assessed using the numerical rating scale, was 1 in all patients. The mean length of hospitalization was 2.09 ± 0.29 days. No procedure-related adverse events occurred within 30 days after the procedure. Postoperative recovery was uneventful, and all patients successfully received enteral nutrition as intended. Conclusion The innovative push-PEG using the 5TAMeD technique with a Foley catheter is feasible and safe. This method offers a minimally invasive and cost-effective option for enteral feeding in patients with advanced esophageal cancer.