Reassessment of the role of enteral tube feedings for patients with esophageal cancer.

[esophageal carcinoma]

Nutrition is important for patients with esophageal cancer because dysphagia can be exacerbated by chemoradiotherapy . Some centers suggest routine enteral tube placement (TF ) to facilitate nutrition . This investigation was to evaluate the use of TF access for patients undergoing multimodality therapy for esophageal carcinoma . This retrospective study analyzed 113 patients who underwent esophagectomy and 97 patients who underwent definition chemoradiotherapy for esophageal cancer between 2001 and 2013 . Throughout this time period , a strategy for selective tube placement was used . Nutrition was assessed through absolute lymphocyte counts , protein , and albumin levels . A total of 28 (30 %) patients during preoperative chemoradiotherapy and 31 (32 %) of those undergoing definitive chemoradiation received TFs . There were 16 Dobhoff tubes , 28 gastrostomy tubes , and 15 jejunostomies . Tubes were maintained an average of 3 .9 months with 20 (34 %) of these patients reporting tube-related complications . At the time of surgery , there was no statistical difference in any of the nutritional assessments between those patients who received TF and those who did not . Both groups experienced similar total postoperative complication rates (64 % vs 65 %) and similar median length of hospital stay (12 to 13 days ). Chemoradiotherapy resulted in decreased nutritional parameters ; however , there was no difference in the degree of reduction between those who underwent TF and those who did not . The data show that routine placement of enteral access is not necessary for esophageal carcinoma . In fact , the risks of placing enteral access may outweigh the benefits . Administration of TF should be restricted to select patients during chemoradiotherapy or before esophagectomy .