scholarly journals Percutaneous endoscopic gastrostomy for nutritional palliation of upper esophageal cancer unsuitable for esophageal stenting

2012 ◽  
Vol 49 (3) ◽  
pp. 227-231 ◽  
Author(s):  
Ana Grilo ◽  
Carla Adriana Santos ◽  
Jorge Fonseca
Keyword(s):  
Body Mass Index ◽  
Esophageal Cancer ◽  
Body Mass ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Nutritional Support ◽  
Oral Intake ◽  
Upper Esophageal Sphincter ◽  
Advanced Esophageal Cancer ◽  
Endoscopic Gastrostomy ◽  
Esophageal Stenting

CONTEXT: Esophageal cancer is often diagnosed at an advanced stage and has a poor prognosis. Most patients with advanced esophageal cancer have significant dysphagia that contributes to weight loss and malnutrition. Esophageal stenting is a widespread palliation approach, but unsuitable for cancers near the upper esophageal sphincter, were stents are poorly tolerated. Generally, guidelines do not support endoscopic gastrostomy in this clinical setting, but it may be the best option for nutritional support. OBJECTIVE: Retrospective evaluation of patients with dysphagia caused advanced esophageal cancer, no expectation of resuming oral intake and with percutaneous endoscopic gastrostomy for comfort palliative nutrition. METHOD: We selected adult patients with unresecable esophageal cancer histological confirmed, in whom stenting was impossible due to proximal location, and chemotherapy or radiotherapy were palliative, using gastrostomy for enteral nutrition. Clinical and nutritional data were evaluated, including success of gastrostomy, procedure complications and survival after percutaneous endoscopic gastrostomy, and evolution of body mass index, albumin, transferrin and cholesterol. RESULTS: Seventeen males with stage III or IV squamous cell carcinoma fulfilled the inclusion criteria. Mean age was 60.9 years. Most of the patients had toxic habits. All underwent palliative chemotherapy or radiotherapy. Gastrostomy was successfully performed in all, but nine required prior dilatation. Most had the gastrostomy within 2 months after diagnosis. There was a buried bumper syndrome treated with tube replacement and four minor complications. There were no cases of implantation metastases or procedure related mortality. Two patients were lost and 12 died. Mean survival of deceased patients was 5.9 months. Three patients are alive 6, 14 and 17 months after the gastrostomy procedure, still increasing the mean survival. Mean body mass index and laboratory parameters were roughly stable 1 and 3 months after the gastrostomy procedure. CONCLUSIONS: In patients with advanced upper esophageal cancer where only palliative treatment is possible, nutritional support is easily achieved with percutaneous endoscopic gastrostomy, allowing patients to be at homes, surviving a significant period of time. Percutaneous endoscopic gastrostomy feeding should be considered as standard definitive nutritional palliation in patients with upper esophageal cancer, unsuitable for esophageal stenting.

Comparison of Introducer Percutaneous Endoscopic Gastrostomy with Open Gastrostomy in Advanced Esophageal Cancer Patients

Dysphagia ◽  
2019 ◽  
Vol 35 (1) ◽  
pp. 117-120 ◽  
Author(s):  
Prasit Mahawongkajit ◽  
Ajjana Techagumpuch ◽  
Palin Limpavitayaporn ◽  
Amonpon Kanlerd ◽  
Ekkapak Sriussadaporn ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Advanced Esophageal Cancer ◽  
Endoscopic Gastrostomy

scholarly journals Percutaneous endoscopic gastrostomy in comprehensive preparing the patients with severe body mass defciency for lung transplantation

2019 ◽  
Vol 11 (1) ◽  
pp. 55-60
Author(s):  
M. Sh. Khubutiya ◽  
A. M. Gasanov ◽  
E. A. Tarabrin ◽  
T. E. Kallagov ◽  
E. I. Pervakova ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cystic Fibrosis ◽  
Enteral Nutrition ◽  
Lung Transplantation ◽  
Body Mass ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Lung Diseases ◽  
Comparison Group ◽  
Waiting List ◽  
Endoscopic Gastrostomy

Introduction. Currently, lung transplantation is an approved method for treating a wide range of end-stage lung diseases refractory to medical or surgical treatments when patient's life expectancy without transplantation makes no more than two years.The aim was to evaluate the efficacy of continuous nutritional support via percutaneous endoscopic gastrostomy in potential recipients of lung transplantation with a Body Mass Index under 16 kg/m2.Material and methods. The study was based on the analysis of 93 potential recipients with various lung diseases; 27 of them with diagnosed cystic fibrosis. The enteral nutrition results of the patients with cystic fibrosis whose Body Mass Index (BMI) was under 16 kg/m2 were assessed by the increment in BMI and compared between those (15) fed via gastrosomy and those (22) fed per os.Results. As a result of enteral nutrition via the gastrostomy in the daytime and at night, the majority of recipients (73.3% of cases) had the Body Mass Index (BMI) corrected from 0.1 to 4.91 kg/m2 during the first year, the mean BMI increment made 1.87 ± 0.4 kg/m2. After the BMI correction, 11 of the 15 potential recipients were included in the waiting list, and 6 of them (40%) underwent lung transplantation. In the comparison group, the BMI increment was 0.9 ± 0.3 kg/m2, also having reached a significant difference compared to the baseline (p = 0.04). However, the BMI increment in the main group was significantly higher than in the comparison group (p = 0.02).Conclusion. A statistically significant increase in BMI in a group of patients with cystic fibrosis and BMI under 16 kg/m2, has been demonstrated after percutaneous endoscopic gastrostomy, which allows extending the criteria for the inclusion in the waiting list for lung transplantation.   

PS02.134: COMPARISON OF PUSH PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH OPEN GASTROSTOMY IN ADVANCED ESOPHAGEAL CANCER PATIENTS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 159-159
Author(s):  
Prasit Mahawongkajit
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Conflicts Of Interest ◽  
Invasive Procedure ◽  
Feeding Tube ◽  
Treatment Quality ◽  
Advanced Esophageal Cancer ◽  
Endoscopic Gastrostomy ◽  
Improve Patient

Abstract Background In esophageal cancer treatment, nutrition by feeding tube has been demonstrated to improve patient tolerance of treatment, quality of life, and long term outcomes. The open gastrostomy and percutaneous endoscopic gastrostomy (PEG) push technique are procedures that avoid cancer cells seeding and also improve patient nutritional status. The aim of this study is to compare the results of the push PEG and open gastrostomy in patients with advanced esophageal cancer. Methods A retrospective study was analyzed in the advanced esophageal cancer patients who indicated and received feeding support between January 2016 and December 2017. Results 28 patients in push PEG and 36 patients in open gastrostomy presented the following comparative data: mean operative duration time shorter in push PEG (11.9 min) than open gastrostomy (35.1 min), less blood loss in push PEG (0.8 mL) than open gastrostomy (5.6 mL), less pain score in push PEG (2.4) than open gastrostomy (5.9) and shorter hospitalization in push PEG (1.8 days) than open gastrostomy (2.6 days). Both groups showed no readmission or 30 day mortality. The adverse events of open gastrostomy demonstrated higher than push PEG group. Conclusion Both push PEG and open gastrostomy were the safe options for advanced esophageal cancer patients indicating for enteral nutrition and to avoid cancer cell seeding. The push PEG demonstrated the effective minimally invasive procedure, was safe and with fewer complications. Disclosure All authors have declared no conflicts of interest.

scholarly journals Laparoscopic Gastrostomy for Far-advanced Esophageal Cancer That Was Difficult to Treat with Percutaneous Endoscopic Gastrostomy

2010 ◽  
Vol 6 (4) ◽  
pp. 190-192
Author(s):  
Takeshi Matsutani ◽  
Eiji Uchida ◽  
Hiroshi Maruyama ◽  
Hideyuki Wakabayashi ◽  
Hiroshi Yoshida ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Advanced Esophageal Cancer ◽  
Endoscopic Gastrostomy ◽  
Laparoscopic Gastrostomy

Metastatic hypopharyngeal and esophageal cancer to a percutaneous endoscopic gastrostomy site

Esophagus ◽  
2008 ◽  
Vol 5 (3) ◽  
pp. 155-156 ◽  
Author(s):  
Naruo Kawasaki ◽  
Yutaka Suzuki ◽  
Takakuni Kato ◽  
Kazuto Tsuboi ◽  
Akira Matsumoto ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Endoscopic Gastrostomy

Artificial nutrition support

2020 ◽  
pp. 1914-1926
Author(s):  
Jeremy Woodward
Keyword(s):  
Body Mass Index ◽  
At Risk ◽  
Weight Loss ◽  
Nutritional Status ◽  
Body Mass ◽  
Oral Intake ◽  
Nutrition Support ◽  
Artificial Nutrition ◽  
Nutrition Screening ◽  
Disease States

The prevalence and relevance of undernutrition in affluent societies is often unrecognized, but nutritional status significantly impacts outcomes in all disease states. Nutrition screening identifies patients at risk of undernutrition and should be carried out in hospitals and community: its components comprise past weight loss, current body mass index, and likely foreseeable nutritional challenges. A body mass index less than 18.5 kg/m2; weight loss of more than 10% over 6 months; or BMI of less than 20 kg/m2 with weight loss of more than 5% over 6 months, are all indicative of undernutrition. Nutrition support is indicated for malnourished patients or those at risk of undernutrition in view of inadequate oral intake or malabsorption. Timing of the intervention depends on the pre-existing nutritional status and the likelihood of restoring adequate intake.

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