Feasibility, acceptability of enteral tube feeding and self-insertion of a nasogastric tube in the nutritional management of digestive cancers, impact on quality of life. Issue 6 (June 2020)

• Record Type: Journal Article
• Authors: Quilliot, Didier; Michot, Niasha; Germain, Lucie; Krier, Justine; Lopez, Anthony; Bresler, Laurent; Ayav, Ahmet; Malgras, Aurélie; Nguyen-Thi, Phi-Linh
• Is Part Of: Clinical nutrition. Volume 39:Issue 6(2020)
• Page Start: 1785
• Page End: 1792
• Publication Date: 2020-06
• Subjects: Enteral tube feeding -- Gastrointestinal cancer -- Chemotherapy -- Surgery -- Quality of life; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2019.07.017
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: No study has evaluated the feasibility of enteral tube feeding (ETF) in undernourished patients with newly diagnosed gastrointestinal (GI) cancer. Objectives: Evaluate the acceptability of ETF in patients unable to increase their dietary intake and with a weight loss >10% or albuminemia <30 g/L or BMI <18.5 before surgery, or a weight loss >5% during chemotherapy. The feasibility of self-insertion of a nasogastric tube was also assessed. Results: A total of 308 patients were nutritionally screened during a one-year period. ETF was indicated in 123 cases. Overall acceptability was 78.9% and was higher when weight loss was >10% (p < 0.0001) and before surgery (p < 0.0001), lower during chemotherapy (p < 0.0001), while not influenced by dietary intake or location of the cancer. Forty patients managed a daily self-insertion of the feeding tube (45.5%) and 48 had a nasogastric tube maintained in place. All Quality of Life (QoL) parameters were significantly improved, notably physical role functioning (+20.9% ± 24.0, p < 0.005) and mental health (+21.0% ± 17.7 p < 0.005). Conclusion: According to the present algorithm, ETF was indicated in 39.9% of cases and accepted in 78.9% of newly diagnosed patients with primary GI cancer while improving QoL. This study strengthens the place of self-insertion of feeding tubes in clinical practise.