Ins and outs of enteral access: part 2--long term access--esophagostomy and gastrostomy.

Access techniques for long-term enteral nutrition (over 4 to 6 weeks) includes cervical esophagostomy and pharyngostomy, gastrostomy, and jejunostomy. Cervical esophagostomy and pharyngostomy are rarely used since the advent of better long-term enteral access techniques that are easier to care for and have fewer complications; they are briefly reviewed only for historical completeness and to condemn their use. The different techniques of gastrostomy tube insertion and their indications, contraindications, advantages, and disadvantages are discussed. Part III (to be published in a later issue) of this series will review feeding jejunostomy.