title: Transnasal esophagogastroduodenoscopy for placement of nasoenteric feeding tubes in patients with severe upper gastrointestinal diseases.
abstract: OBJECTIVE
  To evaluate the feasibility and efficacy of small-caliber transnasal esophagogastroduodenoscopy for the placement of nasoenteric feeding tubes (NET) in patients with severe upper gastrointestinal (GI) diseases.
  
  
  METHODS
  Between January 2007 and March 2010, 51 patients underwent transnasal endoscopy for the placement of NET in Peking University Third Hospital. Indications for NET included esophageal stricture or gastric outlet obstruction because of corrosive esophagitis or gastritis, partial obstruction due to malignancy, stenosis in stoma or efferent loop, gastroparesis, metallic stent in upper GI tract, tracheoesophageal fistula, severe acute pancreatitis, anorexia nervosa and intensive care patients. The tubes were endoscopically placed using the guidewire technique. The position of the tube was confirmed by the immediate second endoscopy or abdominal X-ray. If the initiate placement was not correct, an adjustment or a second placement was conducted immediately.
  
  
  RESULTS
  Initial post-pyloric placement of NET was achieved in 43 of 51 patients (84.3%), but the total success rate reached 98.0% (50/51) after the second placement. The time required for the procedure ranged from 10 to 35 min, with a median time of 20.4 min. Epistaxis occurred in 2 patients. There were no complications of hemorrhage, perforation or aspiration.
  
  
  CONCLUSIONS
  The transnasal endoscopic placement of NET was feasible in patients with upper GI diseases, especially in those with changed anatomy.
authors.affiliation: Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Yong Hui
authors.initials: YH
authors.lastname: Huang
authors.forename: Wei
authors.initials: W
authors.lastname: Yao
authors.forename: Hong
authors.initials: H
authors.lastname: Chang
authors.forename: Chang Ji
authors.initials: CJ
authors.lastname: Guo
authors.forename: San Ren
authors.initials: SR
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System / Q000379:methods*; D004750:Enteral Nutrition / Q000295:instrumentation* / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000628:therapy*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D055815:Young Adult