Palliative nasogastric tube placement for patients with advanced esophageal cancer with nearly total obstruction: Consider the feasibility and acceptability considerations

Abstract

Background: Nasogastric tube (NGT) feeding was reasonable choice for patients with advanced esophageal cancer with a short-life expectancy. Bedside blind NGT placement beyond the nearly total obstruction lesion usually fail and is challenging. Each individual patient might have different cancer stage, tumor location and size, natural course of the disease, technique feasibility, and tolerability of NGT placement. This study evaluates the benefits and limitations of palliative NGT placements for advanced esophageal cancer during their last months of life. Method: Retrospective observation study was performed. We implemented three techniques of palliative NGT placement, compared the advantages and limitations, and evaluated the clinical outcomes in patients advanced esophageal cancer with nearly total obstruction. The present study was performed in at a tertiary care teaching hospital, Taiwan. Patients (n =32) received palliative care, failure of bedside blind NGT placement, and/or NPO (Nil per os) treatment were included. Patients were divided into different palliative NGT placements: guidewire method (n = 6), the drag method (n = 6), push method (n = 10). Results: Success rate of palliative NGT placement was observed in the guidewire method (75%), drag method, (100%), and push method (93%). Compared the palliative NGT groups to NPO group, NGT groups had significantly increased in enteral caloric intake (p < 0.05), serum albumin level (p < 0.01), decreased the length of hospital stay (p = 0.01), but increased the survival time (p = 0.01). Conclusion: Patients who tolerated the NGT placement will able to receive desired caloric intake, decrease length of hospital stay, and increase the overall survival time.