Role of feeding procedures in upper gastro-intestinal malignancy patients undergoing radiotherapy

Authors

  • Sundaram Shanmugasundaram Department of Surgical Oncology, Tirunelveli Medical College Hospital, Tirunelveli, Tamil Nadu, India
  • Deepa Shunmugam Department of Surgical Oncology, Tirunelveli Medical College Hospital, Tirunelveli, Tamil Nadu, India
  • Anitha Gandhi Department of Surgical Oncology, Tirunelveli Medical College Hospital, Tirunelveli, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20193323

Keywords:

Gastrostomy, Jejunostomy, Nutritional supplement, Radiotherapy

Abstract

Background: Malnutrition in cancer patients can limit their response to treatment, surgery, chemotherapy and radiotherapy. Oral supplementation is not feasible in patients with cancers of oral cavity, oropharynx, hypopharynx, oesophagus and oesophagogastric junction (OG junction) who undergo radiotherapy or chemotherapy or in the palliative setting due to the growth itself. To compare open feeding gastrostomy with feeding jejunostomy in terms of improvement in the nutritional status of the cancer patient.

Methods: This prospective comparative study was done in patients with gastro-intestinal malignancies who underwent feeding gastrostomy and jejunostomy before radiotherapy were studied.

Results: In 26 patients, 8 patients underwent FG and 18 patients FJ procedure. There was no statistical difference in the increase or decrease in BMI between the two arms. There was an increase in serum albumin level following the feeding procedures both FG and FJ. 71.4% of patients in the FJ arm expressed a feeling of satiety at three months compared to FG arm where only 28.6% of patients were satisfied.

Conclusions: In our study, patients in both FG and FJ arms were able to maintain the BMI and serum albumin levels so as to complete radiotherapy. Feeding jejunostomy as enteral nutrition access still plays a role in developing countries with limited resources to enable these patients to complete the planned treatment.

References

Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR, et al. Prognostic effects of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med. 1980;69: 491-7.

Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11-48.

August DA, Hubmann MB, American Society for Parenteral and Enteral Nutrition (A.S.P.E.N) Board of Directors. A.S.P.E.N. clinical guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. JPEN J Parenter Enteral Nutr. 2009;33:472-500.

Kondrup J, Rasmussen HH, Hamberg O, Stanga Z, Ad Hoc ESPEN Working Group. Nutritional Risk Screening (NRS-2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22:321-36.

Kondrup J, Allison SP, Elia M, Vellas B, Plauth M, Educational and Clinical Practice Committee, et al. ESPEN Guidelines for Nutrition Screening 2002. Clin Nutr. 2003; 22(4):415-21.

Kudsk KA. Beneficial Effect of Enteral Feeding. Gastrointest Endosc Clin N Am. 2007;17:647-62.

Stamm M. Gastrostomy: a new method. Med News.1894;65:324.

Möller P, Lindberg CG, Zilling T. Gastrectomy by various techniques: evaluation of indications, outcome, and complications. Scand J Gastroenterol. 1999;34(10):1050-4.

Pisano G, Calò PG, Tatti A, Farris S, Erdas E, Licheri S, et al. Surgical gastrostomy when percutaneous endoscopic gastrostomy is not feasible: indications, results and comparison between the two procedures. Chiro Ital. 2008;60(2):261-6.

Tapia J, Murguia R, Garcia R, des los Monteros PE, Oriate E. Jejunostomy: techniques, indications, and complications. World J Surg. 1999;23(6):596-602.

Zhou F, Gao YL, Hu YQ. Therapeutic efficacy of nutritional support by percutaneous endoscopic gastrostomy in critically ill patients: a self-control clinical trial. Pak J Med Sci. 2017;33(1):75-80.

Kumar R, Al-Jashaami L, Chew M, Gerkin R, Nanda R. Does Gastrostomy Tube improve the Long-term Nutritional Outcome in patients with Head and Neck Cancer? Am J Gastroenterol. 2017;112:S685.

Abdelgadir MA, Mahadi SJ, Nasr AO, Ahmed MK. Role of jejunostomy feeding catheter as a model for nutritional support. Int J Surg. 2010;8(6):439-43.

Bezerra AC, Valdir T Jr, Roberto LL, de Souza CN, Adami AN. Surgical gastrostomy: current indications and complications in a university hospital. Rev Col Bras Cir. 2013;40(6):458-62.

Choi AH, O’ Leary MP, Merchant SJ, Sun V, Chao J, Raz DJ, et al. Complications of Feeding Jejunostomy Tubes in Patients with Gastroesophageal Cancer. J Gastrointest Surg. 2017;21(2):259-65.

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Published

2019-07-25

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Original Research Articles