Nutritional Support of Cancer Patients without Oral Feeding: How to Select the Most Effective Technique?

摘要: Background Digestive tumours are among the leading causes of morbidity and mortality. Many cancer patients cannot maintain oral feeding develop malnutrition. The authors aim to: review endoscopic, radiologic surgical techniques for nutritional support in patients; address strategies intervention according to selected technique; establish a decision-making algorithm define best approach specific tumour setting. Summary This is narrative non-systematic based on an electronic search through medical literature using PubMed UpToDate. impossibility maintaining major cause malnutrition head neck (H&N) cancer, oesophageal malignant gastric outlet obstruction. Tube feeding, endoscopic stents gastrojejunostomy three main options. Nasal tubes indicated short-term enteral feeding. Percutaneous gastrostomy (PEG) gold standard when nutrition expected more than 3-4 weeks, especially H&N undergoing definite chemoradiotherapy. A gastropexy push system may be considered avoid seeding. Radiologic alternatives not feasible. Postpyloric intolerant achieved nasoenteric tubes, PEG with jejunal extension, percutaneous jejunostomy jejunostomy. Oesophageal enteric palliative that allow improve quality life. Surgical or EUS-guided recommended fail prolonged survival expected. Nutritional dependent technique chosen. Institutional protocols decision algorithms should developed multidisciplinary basis optimize care. Conclusions Gastroenterologists play central role performing selection most effective must consider type, oncologic therapeutic program, aims patient survival.