Decompressive Tube Esophagostomy: A Forgotten Palliative Procedure?

Old-fashioned but modern tube cervical esophagostomy

BACKGROUND

Nasogastric tubes (NGT) are used widely for feeding and decompressions of stomach, but they are associated with several complications and discomfort. When prolonged use of NGT is required, percutaneous endoscopic gastrostomy (PEG) should be considered. However, PEG is not feasible for patients with previous gastrectomy. We have performed tube cervical esophagostomy (TCE) for such difficult cases of PEG.

METHODS

The current study focused on 7 patients requiring TCE for feeding or decompression from 2004 to 2005 at Tottori Municipal Hospital in Japan.

RESULTS

The procedure is relatively simply to perform under local anesthesia and significant complications were not experienced.

CONCLUSIONS

Feeding or decompressive TCE is useful alternative procedure in patients where PEG is not feasible or unacceptable.

Cervical esophagostomy using indwelling catheter for analysis of gastric physiology in dogs

PURPOSE: To describe the technique of cervical esophagostomy with indwelling catheter for the collection of secretions and study of gastric emptying. METHODS: Esophagostomy was performed in 14 dogs, and a tube was introduced into the animals' stomachs and maintained pervious for eight weeks. The technique consisted of opening the left lateral surface of the neck for insertion of the tube, with the aid of a Mixter forceps, and the subsequent subcutaneous tunneling and exteriorization of the catheter on the dorsum of the animals. RESULTS: Successful use of the tube and its total permeability were observed in 13 animals (92.8%). In one animal, the tube was obstructed by hair, and it was replaced. Formation of a small abscess occurred in 3 animals (21.4%), followed by spontaneous drainage. No accidents occurred, and the bleeding was minimal. No deaths were registered. CONCLUSION: The described technique can be used in similar researches, as well as for animal feeding in investigations of the upper digestive tract, after esophageal resection and in major neck surgeries.