title: Use of gel caps to aid endoscopic insertion of nasogastric feeding tubes: a comparative audit.
abstract: BACKGROUND
  Nutrition is crucial to successful outcomes in peri-operative head and neck cancer patients. Nasogastric feeding tubes are an accepted and safe method of providing enteral nutrition in the short-term. Many methods have been advocated for successfully inserting and securing nasogastric tubes and each practitioner will have his or her preferred technique.
  
  
  OBJECTIVE
  To confirm the effectiveness of using gel caps combined with the flexible nasendoscope for the insertion of nasogastric feeding tubes in head and neck cancer patients following failure of traditional methods.
  
  
  METHODS
  Thirty-five consecutive patients requiring nasogastric feeding tubes were included in this comparative audit. All had failed traditional insertion methods after 2 attempts and were therefore eligible for inclusion. Patients were randomised to undergo attempted insertion with the flexible nasendoscope with or without the use of a gel cap (both methods have been previously described). AUDIT OUTCOME: Primary outcome measures showed no significant difference between the two techniques.
  
  
  CONCLUSIONS
  We found the methodology to be of no greater benefit to our patients when compared to our alternative current practice for failed blind nasogastric tube insertion. We retain this methodology in our armamentarium for difficult circumstances but have continued with our standard practice for most patients needing nasogastric tube placement.
authors.affiliation: Department of Head and Neck Surgery, University College London Hospital, and Department of Medicine, University College London Medical School, London, UK. mrtupile@yahoo.com
authors.forename: Tahwinder
authors.initials: T
authors.lastname: Upile
authors.forename: Paul
authors.initials: P
authors.lastname: Stimpson
authors.forename: Miles
authors.initials: M
authors.lastname: Christie
authors.forename: Jaspal
authors.initials: J
authors.lastname: Mahil
authors.forename: Hitesh
authors.initials: H
authors.lastname: Tailor
authors.forename: Waseem K
authors.initials: WK
authors.lastname: Jerjes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002277:Carcinoma / Q000453:epidemiology / Q000601:surgery; D054869:Clinical Audit; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005782:Gels / Q000009:adverse effects / Q000627:therapeutic use*; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D005782:Gels