TRAQUEOESOPHAGEAL FISTULA PATIENTS FED THROUGH PERCUTANEOUS ENDOSCOPIC GASTROSTOMY/GASTROJEJUNOSTOMY: NUTRITIONAL STATUS AND CLINICAL OUTCOME.
BACKGROUND
tracheoesophageal fistula (TEF) may result from cancer or mechanical ventilation. Endoscopic Gastrostomy or Gastrojejunostomy (PEG/PEG-J) is used for nutritional support.


OBJECTIVE
in TEF-patients, evaluating nutritional status when PEG is performed, safety of PEG/PEG-J and clinical outcome.


METHODS
from the files of PEG/PEG-J feed TEF-patients we collected: clinical data, Body Mass Index, albumin, transferrin and cholesterol when gastrostomy was performed, and clinical outcome globally and according with the TEF cause: Group 1: complication of mechanical ventilation, Group 2: cancer.


RESULTS
twelve patients, 18-91 years (median: 53), 11 PEG, one PEG-J: six complications of ventilation (neurological diseases), 6 cancers. Mean period from TEF diagnosis until gastrostomy: 2 months in Group 1, 10 months in Group 2. In the day of the gastrostomy, patients presented with malnutrition parameters, most strikingly in the cancer group. Group 1: died a single patient, 3 closed the TEF, resuming oral intake, 2 are still PEG-feed. All cancer patients died (7 months after gastrostomy). One needed a jejunal extension to create a PEG-J. No more complications.


CONCLUSIONS
PEG/PEG-J was safe in TEF-patients, but cancer patients underwent gastrostomy too late. In TEF-patients, PEG/PEG-J should be considered in a regular basis, earlier in the disease evolution, before established malnutrition.
GENE - Grupo de Estudo de Nutrição Entérica (Enteral Feeding Team), Bloco de Exames Especias, Piso 3, Hospital Garcia de Orta, Avenida Torrado da Silva, 2800 Almada.. jorgedafonseca@hotmail.com.
Carla Adriana
CA
Santos
GENE - Grupo de Estudo de Nutrição Entérica (Enteral Feeding Team), Bloco de Exames Especias, Piso 3, Hospital Garcia de Orta, Avenida Torrado da Silva, 2800 Almada.. jorgedafonseca@hotmail.com.
Marta
M
Pereira
Department of Respiratory Disorders, Hospital Garcia de Orta, Avenida Torrado da Silva, 2800 Almada.. jorgedafonseca@hotmail.com.
Vera Santos
VS
Martins
GENE - Grupo de Estudo de Nutrição Entérica (Enteral Feeding Team), Bloco de Exames Especias, Piso 3, Hospital Garcia de Orta, Avenida Torrado da Silva, 2800 Almada. CiiEM - Centro de Investigação Interdisciplinar Egas Moniz, Almada (Portugal).. jorgedafonseca@hotmail.com.
Jorge
J
Fonseca
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020776:Endoscopes, Gastrointestinal; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods; D005260:Female; D015390:Gastric Bypass / Q000379:methods; D005774:Gastrostomy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D014138:Tracheoesophageal Fistula / Q000178:diet therapy* / Q000209:etiology / Q000401:mortality; D055815:Young Adult