title: Palliative enteral feeding for patients with malignant esophageal obstruction: a retrospective study.
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.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No 325, Section 2, Cheng-Kung Road, Neihu 11490, Taipei, Taiwan. youngwayleon@gmail.com.
authors.forename: C W
authors.initials: CW
authors.lastname: Yang
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No 325, Section 2, Cheng-Kung Road, Neihu 11490, Taipei, Taiwan. redstone120@yahoo.com.tw.
authors.forename: H H
authors.initials: HH
authors.lastname: Lin
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No 325, Section 2, Cheng-Kung Road, Neihu 11490, Taipei, Taiwan. TYH1216@MS46.HINET.NET.
authors.forename: T Y
authors.initials: TY
authors.lastname: Hsieh
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No 325, Section 2, Cheng-Kung Road, Neihu 11490, Taipei, Taiwan. weikuohome@hotmail.com.
authors.forename: W K
authors.initials: WK
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000592:standards / Q000706:statistics & numerical data*; D004750:Enteral Nutrition / Q000379:methods*; D004938:Esophageal Neoplasms / Q000150:complications / Q000178:diet therapy*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods* / Q000592:standards; D012189:Retrospective Studies