Repurposing medical devices as “button” esophagostomy tubes for extended nutritional support

Nutrition is essential for patient recovery and energy supply is strongly associated with hospital discharge. For this purpose, hospitalized animals often undergo a feeding tube placement, that for the long term should be esophageal (E-tubes).

In animals, it is particularly important to be less invasive and to interfere minimally with natural behavior, and common E-tubes end up having long external tubing, the need for skin sutures and neck bandaging. This study proposes that low profile (LP) tubes intended for enteral feeding in humans, can be safely used as LP E-tubes in dogs, and describes, for the first time, the use of an LP E-tube on a dog.

Conclusions were that by eliminating the external tubing, bandaging and skin sutures, the invasiveness of the E-tube was reduced allowing the dog to behave naturally and decreasing the probability of dislodgement by the patient. Standard E-tubes need skin sutures, which cause swelling and redness. With the LP E-tube the patient’s stoma appearance improved compared to the regular E-tube. However, it is important to mention that greater handling of the tube is required at the stoma for attachment of the extension set, which requires the use of gloves to avoid infection.

The most common cause for LP tubes to fail is balloon leaks or ruptures in children. However, these are allocated in the acidic gastric lumen, whereas LP E-tubes are placed on the non-acidic esophageal lumen. For this reason, less balloon degradation should be expected.

The main disadvantage is the cost compared with standard E-tubes. But the potential benefit and stoma health advantage should be considered when these tubes have to be used for long periods of time.
Future studies with a larger patient number are warranted to better understand these tubes longevity and complication rates.