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Background

Oesophagostomy tube placement is a common occurrence in veterinary practice and indicated in cases where nutritional support may be required for weeks or months. They are used to administer nutrition in the anorexic patient or those where oral feeding is contraindicated. They are contraindicated in patients with oesophageal disorders, delayed gastric emptying and vomiting.

Recognised complications from oesophageal tube placement includes general anaesthesia risk, infection at the stoma site, jugular vein disruption during placement or dislodging of the tube due to vomiting or regurgitation.
This study was undertaken to ascertain if placement methodology impacted on post placement complications or development of infection at the stoma site.

Methods
Only cats and dogs having oesophageal feeding tubes placed as part of their clinical care were recruited for this study. Standardised information was recorded both during and after placement.

All feeding tubes were placed by Veterinary Surgeons under general anaesthesia in either left or right lateral recumbency and in line with current standard operating procedure guidelines, ensuring standardisation of placement within hospital areas.

Post-operative care of oesophageal feeding tubes was standardised and performed daily by a registered Veterinary Nurse (RVN), VS or student under the direct supervision of an RVN or VS. The condition of the tube and stoma was observed and evaluated daily using a stoma score designed for this study. This was recorded for 7 days post placement or less if the patient was discharged; the tube was displaced or removed.

Results
In this study, no serious complications associated with oesophagostomy tube placement were identified. There were no situations where it was necessary to remove the oesophagostomy tube on veterinary recommendation due to concern relating to stoma site infection.

Clinical Significance
From a clinical perspective the results of this study demonstrate that the placement protocol used is safe and the risk of minor complication associated with oesophageal tube placement is very low. It is common for there to be mild reaction around the stoma site, but this is typically self-limiting and does not require intervention beyond daily oesophagostomy stoma site care. There is no evidence to suggest a change to current placement protocol.