scholarly journals Usefulness of Percutaneous Transesophageal Gastro-Tubing in Patients Receiving Chemoradiotherapy for Advanced Esophageal Cancer: A Case Report

2019 ◽  
Vol 12 (3) ◽  
pp. 901-908 ◽  
Author(s):  
Atsushi Naganuma ◽  
Ayaka Kishi ◽  
Yusuke Ogawa ◽  
Tomohiro Kudo ◽  
Yoshizumi Kitamoto ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Nasogastric Tube ◽  
Feeding Tube ◽  
Radiation Dermatitis ◽  
Nutritional Management ◽  
Advanced Esophageal Cancer ◽  
Enteral Feeding Tube ◽  
Endoscopic Gastrostomy ◽  
Irradiation Field ◽  
Patients At Risk

Percutaneous endoscopic gastrostomy (PEG) is often performed for nutritional management in advanced esophageal cancer. We here report a patient who initially received enteral nutrition via a nasogastric tube and in whom the subsequent use of percutaneous transesophageal gastro-tubing (PTEG) circumvented the need for a gastrostomy. It is believed that PEG is less painful than a nasogastric tube. However, we selected PTEG because a PEG would have been within the planned irradiation field and there was concern about radiation dermatitis. We were able to administer chemoradiotherapy with sufficient nutrition via an enteral feeding tube via esophagostomy. PTEG is a very useful tool in patients at risk of radiation dermatitis of the abdomen.

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.

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

Palliative nasogastric tube placement for patients with advanced esophageal cancer with nearly total obstruction: Consider the feasibility and acceptability considerations

2019 ◽  
Author(s):  
CHIH WEI YANG ◽  
I-Hsuan Huang ◽  
Wei-Kuo Chang
Keyword(s):  
Esophageal Cancer ◽  
Hospital Stay ◽  
Survival Time ◽  
Nasogastric Tube ◽  
Tertiary Care ◽  
Caloric Intake ◽  
Length Of Hospital Stay ◽  
Tube Placement ◽  
Advanced Esophageal Cancer ◽  
Observation Study

Abstract Background: Nasogastric tube (NGT) feeding was reasonable choice for patients with advanced esophageal cancer with a short-life expectancy. Bedside blind NGT placement beyond the nearly total obstruction lesion usually fail and is challenging. Each individual patient might have different cancer stage, tumor location and size, natural course of the disease, technique feasibility, and tolerability of NGT placement. This study evaluates the benefits and limitations of palliative NGT placements for advanced esophageal cancer during their last months of life. Method: Retrospective observation study was performed. We implemented three techniques of palliative NGT placement, compared the advantages and limitations, and evaluated the clinical outcomes in patients advanced esophageal cancer with nearly total obstruction. The present study was performed in at a tertiary care teaching hospital, Taiwan. Patients (n =32) received palliative care, failure of bedside blind NGT placement, and/or NPO (Nil per os) treatment were included. Patients were divided into different palliative NGT placements: guidewire method (n = 6), the drag method (n = 6), push method (n = 10). Results: Success rate of palliative NGT placement was observed in the guidewire method (75%), drag method, (100%), and push method (93%). Compared the palliative NGT groups to NPO group, NGT groups had significantly increased in enteral caloric intake (p < 0.05), serum albumin level (p < 0.01), decreased the length of hospital stay (p = 0.01), but increased the survival time (p = 0.01). Conclusion: Patients who tolerated the NGT placement will able to receive desired caloric intake, decrease length of hospital stay, and increase the overall survival time.

Results of neoadjuvant chemoradiotherapy with docetaxel, cisplatin, and 5-fuluorouracil for advanced esophageal cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 171-171
Author(s):  
Manabu Emi ◽  
Yoichi Hamai ◽  
Yuta Ibuki ◽  
Morihito Okada
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Phase I ◽  
Primary Tumor ◽  
Gastric Tube ◽  
Neoadjuvant Chemoradiotherapy ◽  
Complete Response ◽  
Advanced Esophageal Cancer ◽  
Level Ii ◽  
Irradiation Field

171 Background: We previously reported a phase I study of neoadjuvant chemoradiotherapy (CRT ) with docetaxel, cisplatin, and 5-fuluorouracil (DCF) for advanced esophageal cancer. After that, we continued to conduct neoadjuvant CRT with DCF as phase II study and here, we report the results of this study including phase I. Methods: We performed neoadjuvant CRT with DCF chemotherapy and concurrent radiation therapy (40Gy including irradiation field) in patients with advanced esophageal squamous cell carcinoma. Dose of chemotherapy were as follows: docetaxel 25mg/m2 (level 1 n=17), or 30mg/m2 (level 2 n=4) on day 1,15,29 and 43 and cisplatin 70mg/m2 on day 1,29 and 5-fuluorouracil on day 1-4 and 29-32. The tumors were resected during weeks 10-13. Results: From Dec 2009 to Aug 2012, 21patients were enrolled and 19 patients underwent thoracic surgery. There were 17 male and four female subjects of ages ranging from 38 to 72 years (median, 61 years). Of these, 6 patients had stage IIIA esophageal cancer and two had stage IIIB esophageal cancer. All the patients had squamous cell carcinoma. Pathological complete response of primary tumor was achieved in 12 patients (63%) and complete pathological response of both primary tumor and lymph node was seen in eight patients (42%). During CRT, the most common grade 3/4 non-hematological toxicity were anorexia (29%) and esophagitis (29%). During CRT, septic shock caused by infection via catheter was observed and re-operation was performed in one patient with reconstructed gastric tube necrosis.One patient developed recurrent gastric tube ulcer in the anastomotic part 4years after esophagectomy. 10 patients are alive more than 5 years and 5-year overall survival is 47.6% and three of them were level II cases. Conclusions: This preoperative CRT regimen using triplets result in favorite prognosis, but treatment plan should be reconsidered because of relative high toxicity. Because high complete response rate of primary tumor were observed and long-term survival has been obtained at a high rate in the case of level II, we planned new phase I/II study of CRT with DCF without preventive irradiation field. Clinical trial information: R000002555.

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.

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