New MethodNasogastric feeding tube placement in patients with esophageal cancer: application of ultrathin transnasal endoscopy
Section snippets
Patients
Consecutive patients with esophageal cancer were referred to our hospital from November 2001 to October 2002 for ultrathin-endoscopic–guided NG-tube placement because traditional NG-tube–placement methods failed. NG-tube placement for nutrition was attempted at the bedside but failed because of an inability to pass the tubes beyond the obstructing esophageal lesions. Written informed consent was obtained from each patient. Exclusion criteria included patients with facial and basilar skull
Results
A total of 71 NG feeding tubes were placed in 40 patients (37 men, 3 women; age 57 ± 15 years; range, 37-91 years), including 39 patients with squamous-cell carcinoma of the esophagus and 1 patient with adenocarcinoma. Several of the patients (17/40, 43%) had a middle third lesion (between 27 and 35 cm from the incisors). The tumor was located in the upper third of the esophagus (between upper esophageal sphincter and 27 cm level from the incisors) in 10 cases (10/40, 25%) and the lower third
Discussion
The negative impact of weight loss on morbidity and mortality of patients with cancer is well known. Weight loss may decrease the response to chemotherapy, as well as tolerance to both radiotherapy and chemotherapy.27 Total parenteral nutrition may cause metabolic problems and mechanical and infectious complications related to the insertion of intravenous catheters and keeping them in place. The natural access to the body, the large assortment of tube feedings, and the low frequency of
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2018, Techniques in Gastrointestinal EndoscopyCitation Excerpt :The endoscope is removed and the tube is then passed over the wire into the stomach [73]. The success rates of the transnasal technique in esophageal cancer patients are as high as 99%, but 30% of these patients need dilatation of the stricture site [73]. For long-term enteral support or in a case where ENET cannot be performed, PEE is usually used for feeding.
Enteral nutrition and quality of life in patients undergoing chemoradiotherapy for esophageal carcinoma: a comparison of nasogastric tube, esophageal stent, and ostomy tube feeding
2018, Gastrointestinal EndoscopyCitation Excerpt :If the patient developed severe odynophagia or progressive dysphagia just before or during CRT, we commonly performed (endoscopic-guided) NGT insertion to avoid delay or interruption of cancer treatment. This method had a 99% success rate with very low procedure-related adverse events.7 In brief, the ultrathin scope was inserted from the nostril, past the tumor, and entered the stomach; then the guidewire was indwelled through the working channel into the antrum.
Novel procedure of circular stapler-guided nasogastric tube insertion during esophageal reconstruction
2011, Journal of the American College of SurgeonsCitation Excerpt :In addition, blindly grasping the nasogastric tube in the cervical esophagus can damage the esophageal mucosa. Several reports have been published on alternative techniques for inserting the nasogastric tube under endoscopic guidance4,5; however, these procedures often require substantial time and effort. In the past, we had performed an insertion method using a Nelaton catheter and this method was useful and certain1; however, the anastomosis can be damaged when the Nelaton catheter is inserted from the proximal end of the gastric tube.