Endoscopically guided placement of nasogastric tubes in patients with esophageal carcinoma with absolute dysphagia: report of a 3-year experience.

Esophageal cancer often leads to total or near-total dysphagia, necessitating placement of nasogastric tubes for nutritional support. In patients with failed blind intubation or even failed fluoroscopic-guided tube placement, endoscopic guidance has a role to play. The catheter-over-guidewire technique is simple, safe, and easy to use. Over a period of 3 years, it was used in 28 patients who had esophageal cancer with 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 procedure-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 be considered in preference to fluoroscopic assistance if endoscopic facilities are available.