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Retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures

Locally advanced esophageal cancer often presents with dysphagia and can be complicated by aspiration pneumonia. Therefore, nutritional management is important to prevent pneumonia. Enteral nutrition via gastrostomies is common in esophageal cancer patients. Here, we describe the efficacy of nutriti...

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Autores principales: Yamashita, Takeshi, Otsuka, Koji, Goto, Satoru, Ariyoshi, Tomotake, Motegi, Kentaro, Kohmoto, Masahiro, Saito, Akira, Sato, Yoshihito, Kishimoto, Yutaka, Murakami, Masahiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661824/
https://www.ncbi.nlm.nih.gov/pubmed/38023668
http://dx.doi.org/10.1002/deo2.321
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author Yamashita, Takeshi
Otsuka, Koji
Goto, Satoru
Ariyoshi, Tomotake
Motegi, Kentaro
Kohmoto, Masahiro
Saito, Akira
Sato, Yoshihito
Kishimoto, Yutaka
Murakami, Masahiko
author_facet Yamashita, Takeshi
Otsuka, Koji
Goto, Satoru
Ariyoshi, Tomotake
Motegi, Kentaro
Kohmoto, Masahiro
Saito, Akira
Sato, Yoshihito
Kishimoto, Yutaka
Murakami, Masahiko
author_sort Yamashita, Takeshi
collection PubMed
description Locally advanced esophageal cancer often presents with dysphagia and can be complicated by aspiration pneumonia. Therefore, nutritional management is important to prevent pneumonia. Enteral nutrition via gastrostomies is common in esophageal cancer patients. Here, we describe the efficacy of nutritional management using a gastrojejunostomy tube retrogradely inserted in the esophagus through gastrostomy to simultaneously drain accumulated fluid on the proximal side of a malignant stricture. We performed this procedure for two cases with severe malignant strictures using two types of endoscope insertion. A 57‐year‐old male patient (Case 1) underwent a retrograde insertion of a gastrojejunostomy tube for severe esophageal malignant stricture with severe nausea and salivary reflux. After a narrow endoscope was inserted through the gastrostomy fistula, a gastrojejunostomy tube was inserted alongside a guidewire allowing the patient to undergo definitive chemoradiotherapy without symptoms. An 82‐year‐old male patient (Case 2) was scheduled for a minimally invasive esophagectomy following neoadjuvant chemotherapy after gastrostomy. However, the patient developed aspiration pneumonia due to salivary reflux; before surgery, a narrow nasal endoscope was inserted and passed through the strictures. The percutaneous endoscopic transgastric jejunostomy catheter was retrogradely inserted alongside the guidewire. In patients with malignant strictures and salivary reflux, retrograde insertion of gastrojejunostomy tubes can simultaneously provide enteral nutrition and saliva drainage.
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spelling pubmed-106618242023-11-20 Retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures Yamashita, Takeshi Otsuka, Koji Goto, Satoru Ariyoshi, Tomotake Motegi, Kentaro Kohmoto, Masahiro Saito, Akira Sato, Yoshihito Kishimoto, Yutaka Murakami, Masahiko DEN Open Case Reports Locally advanced esophageal cancer often presents with dysphagia and can be complicated by aspiration pneumonia. Therefore, nutritional management is important to prevent pneumonia. Enteral nutrition via gastrostomies is common in esophageal cancer patients. Here, we describe the efficacy of nutritional management using a gastrojejunostomy tube retrogradely inserted in the esophagus through gastrostomy to simultaneously drain accumulated fluid on the proximal side of a malignant stricture. We performed this procedure for two cases with severe malignant strictures using two types of endoscope insertion. A 57‐year‐old male patient (Case 1) underwent a retrograde insertion of a gastrojejunostomy tube for severe esophageal malignant stricture with severe nausea and salivary reflux. After a narrow endoscope was inserted through the gastrostomy fistula, a gastrojejunostomy tube was inserted alongside a guidewire allowing the patient to undergo definitive chemoradiotherapy without symptoms. An 82‐year‐old male patient (Case 2) was scheduled for a minimally invasive esophagectomy following neoadjuvant chemotherapy after gastrostomy. However, the patient developed aspiration pneumonia due to salivary reflux; before surgery, a narrow nasal endoscope was inserted and passed through the strictures. The percutaneous endoscopic transgastric jejunostomy catheter was retrogradely inserted alongside the guidewire. In patients with malignant strictures and salivary reflux, retrograde insertion of gastrojejunostomy tubes can simultaneously provide enteral nutrition and saliva drainage. John Wiley and Sons Inc. 2023-11-20 /pmc/articles/PMC10661824/ /pubmed/38023668 http://dx.doi.org/10.1002/deo2.321 Text en © 2023 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Reports
Yamashita, Takeshi
Otsuka, Koji
Goto, Satoru
Ariyoshi, Tomotake
Motegi, Kentaro
Kohmoto, Masahiro
Saito, Akira
Sato, Yoshihito
Kishimoto, Yutaka
Murakami, Masahiko
Retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures
title Retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures
title_full Retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures
title_fullStr Retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures
title_full_unstemmed Retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures
title_short Retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures
title_sort retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10661824/
https://www.ncbi.nlm.nih.gov/pubmed/38023668
http://dx.doi.org/10.1002/deo2.321
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