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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
"dysphagia"
symptom
alexander disease
cadasil
cushing syndrome
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
inclusion body myositis
kindler syndrome
liposarcoma
locked-in syndrome
neuralgic amyotrophy
oligodontia
triple a syndrome
well-differentiated liposarcoma
This symptom has already been validated