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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Palliative Care 1/2015

Palliative enteral feeding for patients with malignant esophageal obstruction: a retrospective study

Zeitschrift:
BMC Palliative Care > Ausgabe 1/2015
Autoren:
CW. Yang, HH. Lin, TY. Hsieh, WK. Chang
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12904-015-0056-5) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

WKC contributed to the study design, extracted the data, interpreted the results, critically revised the manuscript for important content, and supervised the study. TYH contributed to study design, interpreted the results, and critically revised the manuscript for important content. HHL interpreted the results and contributed to the data analysis. CWY contributed to the analysis plan, interpreted the results, and wrote the manuscript. All authors have read and approved the final version.

Abstract

Background

Malignant esophageal obstruction leads to dysphagia, deterioration in quality of life, and malnutrition. Traditional bedside nasogastric (NG) tube placement is very difficult under these circumstances. However, endoscopically assisted NG tube placement under fluoroscopic guidance could be an alternative option for establishing palliative enteral nutrition. This study aimed to compare the clinical outcomes of enteral tube feeding and esophageal stenting for patients with malignant esophageal obstruction and a short life expectancy.

Methods

Thirty-one patients were divided into 3 groups according to their treatment modality: NG tube (n = 12), esophageal stent group (n = 10), and supportive care with nil per os (NPO) (n = 9). Enteral nutrition, clinical outcomes, length of hospital stay, and median survival were evaluated.

Results

There were no significant baseline differences among the groups, except in age. The tube and stent groups had significantly higher enteral calorie intake (p = 0.01), higher serum albumin (p < 0.01), shorter hospital stay (p = 0.01), and longer median survival (p < 0.01) than the NPO group. The incidence of dislodgement in the tube group was significantly higher than in the stent group (58 % vs. 20 %, respectively; p = 0.01). However, stenting costs more than NG tube placement.

Conclusions

Palliative enteral feeding by NG tube is safe, inexpensive, and has a low complication rate. Endoscopically assisted NG tube placement under fluoroscopic guidance could be a feasible palliative option for malignant esophageal obstruction for patients who have a short life expectancy.
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