ENDOSCOPICALLY GUIDED PLACEMENT OF NASOGASTRIC TUBES IN PATIENTS WITHESOPHAGEAL-CARCINOMA WITH ABSOLUTE DYSPHAGIA - REPORT OF A 3-YEAR EXPERIENCE

Esophageal cancer often leads to total or near-total dysphagia, necess itating placement of nasogastric tubes for nutritional support. In pat ients with failed blind intubation or even failed fluoroscopic-guided tube placement, endoscopic guidance has a role to play. The catheter-o ver-guidewire technique is simple, safe, and easy to use. Over a perio d of 3 years, it was used in 28 patients who had esophageal cancer wit h absolute dysphagia. Successful placement of Levin tubes was achieved in 21 (75%) of these patients. Failure was more common in upper third lesions. The procedure was done on an outpatient basis, and no proced ure-related complications were recorded in this series. To summarize, endoscopically assisted nasogastric tube placement is a useful option in esophageal cancer when blind intubation has failed, and it should b e considered in preference to fluoroscopic assistance if endoscopic fa cilities are available. (C) 1994 Wiley-Liss, Inc.