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 .

Diseases
Validation

Diseases presenting "cancer" symptom

achondroplasia

acute rheumatic fever

adrenal incidentaloma

alpha-thalassemia

benign recurrent intrahepatic cholestasis

cadasil

canavan disease

carcinoma of the gallbladder

cholangiocarcinoma

coats disease

congenital adrenal hyperplasia

congenital diaphragmatic hernia

cowden syndrome

cushing syndrome

cutaneous mastocytosis

dedifferentiated liposarcoma

dystrophic epidermolysis bullosa

epidermolysis bullosa simplex

erdheim-chester disease

erythropoietic protoporphyria

esophageal adenocarcinoma

esophageal carcinoma

esophageal squamous cell carcinoma

familial hypocalciuric hypercalcemia

familial mediterranean fever

gm1 gangliosidosis

heparin-induced thrombocytopenia

hereditary cerebral hemorrhage with amyloidosis

hirschsprung disease

hodgkin lymphoma, classical

inclusion body myositis

junctional epidermolysis bullosa

kabuki syndrome

kallmann syndrome

kindler syndrome

lamellar ichthyosis

liposarcoma

locked-in syndrome

lymphangioleiomyomatosis

monosomy 21

neuralgic amyotrophy

oculocutaneous albinism

oligodontia

oral submucous fibrosis

papillon-lefèvre syndrome

pendred syndrome

pleomorphic liposarcoma

primary effusion lymphoma

proteus syndrome

pyomyositis

pyruvate dehydrogenase deficiency

severe combined immunodeficiency

sneddon syndrome

systemic capillary leak syndrome

triple a syndrome

von hippel-lindau disease

waldenström macroglobulinemia

well-differentiated liposarcoma

werner syndrome

wiskott-aldrich syndrome

wolf-hirschhorn syndrome

x-linked adrenoleukodystrophy

This symptom has already been validated