How to maintain nutritional status after esophagectomy via the Tanaka method

Tanaka, Yoshihiro; Sato, Yuta; Suetsugu, Tomonari; Mase, Junichi; Takaha, Ritsuki; Okumura, Naoki; Matsuhashi, Nobuhisa; Takahashi, Tsuyoshi; Yoshida, Kazuhiro

doi:10.20517/2394-4722.2021.151

Cited by 1 publication

(1 citation statement)

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“…In chemotherapy and CRT, many advantages of enteral nutrition have been reported, including maintenance of the intestinal mucosa (prevention of intestinal mucosal atrophy), maintenance of immunocompetence, maintenance of physiological functions of the digestive tract (intestinal peristalsis, digestive tract hormone secretion), avoidance of bacterial translocation, avoidance of bile stasis, and easy long-term management [27]. We provided enteral nutrition overnight during chemotherapy and used enteral and oral nutritional supplements after surgery [28,29].…”

Section: Discussionmentioning

confidence: 99%

A case of advanced hypopharyngeal cervical esophageal cancer treated by curative resection with management of tracheoesophageal fistula

Ohno

Tanaka

Sato

et al. 2023

Clin J Gastroenterol

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Advanced esophageal cancer with tracheal invasion is fatal due to airway narrowing and the possibility of tracheoesophageal fistula (TEF) formation during the treatment process. If a TEF develops, palliative care is often chosen. It is very rare that curative treatment is performed including with chemoradiotherapy (CRT) or surgery in such cases. A 71-year-old man presented with dysphagia. He was diagnosed as having hypopharyngeal and cervical esophageal cancer with severe airway stenosis (cT4b [main bronchus, thyroid] N3 M0 cStage IIIC), and we initially created a tracheostomy. Second, we chose induction chemotherapy to avoid fistula formation by CRT, but after one course of chemotherapy, he developed a TEF due to remarkable tumor shrinkage. We strictly managed both his airway and nutrition by continuous suctioning over the cuff of the tracheal cannula and prohibiting swallowing of saliva and enteral nutrition via nasogastric tube. After three courses of chemotherapy were administered, we performed pharyngo-laryngo-esophagectomy followed by adjuvant chemotherapy. The patient remains alive and recurrence free at 9 years postoperatively. In cases of upper TEF caused by advanced hypopharyngeal and cervical esophageal cancer, radical treatment may be possible by effective induction chemotherapy combined with strict airway and nutritional management after prior tracheostomy.

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Section: Discussionmentioning

confidence: 99%