Percutaneous endoscopic gastrostomy feeding of locally advanced oro-pharygo-laryngeal cancer patients

Papakostas, Pyrros; Tsaousi, Georgia; Stavrou, George; Rachovitsas, Dimitrios; Tsiropoulos, Gavriil; Rova, Constantina; Konstantinidis, Ioannis; Michalopoulos, Antonios; Grosomanidis, Vasilios; Kotzampassi, Katerina

doi:10.1016/j.oraloncology.2017.10.001

Cited by 18 publications

(58 citation statements)

References 48 publications

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“…In this study, a care package was provided to the patients in addition to the commercial tube feed which complicates the interpretation of the reported outcomes [107]. In another study, commercial tube feed was found to be relatively more beneficial over an 8-month period for patients with head and neck cancer compared to either blended tube feed or blended diet used as a tube feed [108]. All of the study groups had additional oral intake recommended, and therefore a consideration of their oral intake over the study period would have been beneficial.…”

Section: Products Recommended For Henmentioning

confidence: 98%

ESPEN guideline on home enteral nutrition

et al. 2020

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This guideline will inform physicians, nurses, dieticians, pharmacists, caregivers and other home enteral nutrition (HEN) providers about the indications and contraindications for HEN, and its implementation and monitoring. Home parenteral nutrition is not included but will be addressed in a separate ESPEN guideline. This guideline will also inform interested patients requiring HEN. The guideline is based on current evidence and expert opinion and consists of 61 recommendations that address the indications for HEN, relevant access devices and their use, the products recommended, the monitoring and criteria for termination of HEN, and the structural requirements needed to perform HEN. We searched for metaanalyses, systematic reviews and single clinical trials based on clinical questions according to the PICO format. The evidence was evaluated and used to develop clinical recommendations implementing the SIGN method. The guideline was commissioned and financially supported by ESPEN and the members of the guideline group were selected by ESPEN.

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Section: Products Recommended For Henmentioning

confidence: 98%

ESPEN guideline on home enteral nutrition

et al. 2020

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“…Although the BMI declined across all groups after 8 weeks of concurrent chemoradiation therapy, the BTF intervention group had a significantly greater decline in BMI than the CEF group and HEF group ( P = .041) 15 . After 8 months of treatment, the BMI of the HEF group continued to significantly decline compared with baseline and at 8 weeks ( P < .0001) 15 . However, the BTF group's BMI showed a slight but significant improvement at 8 months compared with their BMI at 8 weeks of treatment ( P < .0001) 15 .…”

Section: Resultsmentioning

confidence: 89%

“…The BTF group consumed the same foods as the rest of their family, except the foods were blenderized and researchers did not know the nutrition composition of this diet 15 . In contrast, the HEF was a blenderized diet of known nutrition composition that was designed by a registered dietitian 15 . Although the BMI declined across all groups after 8 weeks of concurrent chemoradiation therapy, the BTF intervention group had a significantly greater decline in BMI than the CEF group and HEF group ( P = .041) 15 .…”

Section: Resultsmentioning

confidence: 99%

“…In contrast, the HEF was a blenderized diet of known nutrition composition that was designed by a registered dietitian 15 . Although the BMI declined across all groups after 8 weeks of concurrent chemoradiation therapy, the BTF intervention group had a significantly greater decline in BMI than the CEF group and HEF group ( P = .041) 15 . After 8 months of treatment, the BMI of the HEF group continued to significantly decline compared with baseline and at 8 weeks ( P < .0001) 15 .…”

Section: Resultsmentioning

confidence: 99%

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Clinical Outcomes Associated With Commercial and Homemade Blenderized Tube Feedings: A Literature Review

2020

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There is emerging evidence in the pediatric population that blenderized tube feeding (BTF) may improve gastrointestinal intolerance; however, not much is known about the impact of BTF on clinical outcomes in adults. This article presents a review of the literature published in the past 10 years that explored the impact of BTF on nutrition status (ie, weight status, body mass index, and upper-arm circumference) and nutrition adequacy in adults. The results indicate that BTF, compared with commercial enteral formula (CEF), may be inadequate in calories, macronutrients, and some micronutrients, given variability in BTF formula composition. As a result, BTF may result in significantly more weight loss than CEF. Thus, BTF may not be appropriate for adult patients who are malnourished or are at risk for malnutrition due to the potential worsening of clinical outcomes.

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“…Nevertheless, they are more likely to cause tube blockage, are often nutritionally unbalanced and present an increased risk of bacterial contamination. Also, they are not suitable for patients on postpyloric feeding [78,85,86]. After oesophageal/enteric stenting, oral feeding should be initiated with fluids and gradually progress to a soft diet.…”

Section: Nutritional Intervention For Cancer Patients Without Oral Fementioning

confidence: 99%

Nutritional Support of Cancer Patients without Oral Feeding: How to Select the Most Effective Technique?

Nunes

Fonseca

Barata

et al. 2019

GE Port J Gastroenterol

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Background: Digestive tumours are among the leading causes of morbidity and mortality. Many cancer patients cannot maintain oral feeding and develop malnutrition. The authors aim to: review the endoscopic, radiologic and surgical techniques for nutritional support in cancer patients; address the strategies for nutritional intervention according to the selected technique; and establish a decision-making algorithm to define the best approach in a specific tumour setting. Summary: This is a narrative non-systematic review based on an electronic search through the medical literature using PubMed and UpToDate. The impossibility of maintaining oral feeding is a major cause of malnutrition in head and neck (H&N) cancer, oesophageal tumours and malignant gastric outlet obstruction. Tube feeding, endoscopic stents and gastrojejunostomy are the three main nutritional options. Nasal tubes are indicated for short-term enteral feeding. Percutaneous endoscopic gastrostomy (PEG) is the gold standard when enteral nutrition is expected for more than 3-4 weeks, especially in H&N tumour and oesophageal cancer patients undergoing definite chemoradiotherapy. A gastropexy push system may be considered to avoid cancer seeding. Radiologic and surgical gastrostomy are alternatives when an endoscopic approach is not feasible. Postpyloric nutrition is indicated for patients intolerant to gastric feeding and may be achieved through nasoenteric tubes, PEG with jejunal extension, percutaneous endoscopic jejunostomy and surgical jejunostomy. Oesophageal and enteric stents are palliative techniques that allow oral feeding and improve quality of life. Surgical or EUS-guided gastrojejunostomy is recommended when enteric stents fail or prolonged survival is expected. Nutritional intervention is dependent on the technique chosen. Institutional protocols and decision algorithms should be developed on a multidisciplinary basis to optimize nutritional care. Conclusions: Gastroenterologists play a central role in the nutritional support of cancer patients performing endoscopic techniques that maintain oral or enteral feeding. The selection of the most effective technique must consider the cancer type, the oncologic therapeutic program, nutritional aims and expected patient survival.

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Percutaneous endoscopic gastrostomy feeding of locally advanced oro-pharygo-laryngeal cancer patients

Cited by 18 publications

References 48 publications

ESPEN guideline on home enteral nutrition

ESPEN guideline on home enteral nutrition

Clinical Outcomes Associated With Commercial and Homemade Blenderized Tube Feedings: A Literature Review

Nutritional Support of Cancer Patients without Oral Feeding: How to Select the Most Effective Technique?

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