Monica T Young1, Hung Troung2, Alana Gebhart2, Anderson Shih2, Ninh T Nguyen3. 1. Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA. mtyoung@uci.edu. 2. Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA. 3. Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA. ninhn@uci.edu.
Abstract
BACKGROUND: Jejunostomy catheters for jejunal feeding are an effective method to improve nutritional status in malnourish patients. However, this procedure is commonly being performed using an open approach, which can be associated with more postoperative pain and prolonged recovery. The objective of this study was to assess the outcomes of patients who underwent placement of feeding jejunostomy using a laparoscopic approach. METHODS: A retrospective review was performed of patients who underwent laparoscopic jejunostomy tube placement between 1998 and 2014. Main outcome measures included indication for catheter placement, rate of conversion rate to open surgery, perioperative and late morbidity and in-hospital mortality. RESULTS: Two hundred and ninety-nine consecutive patients underwent laparoscopic jejunostomy during the study period. The mean age was 64 years, and 81% of patients were male. The mean BMI was 26.2 kg/m(2). The most common indications for catheter placement were resectable esophageal cancer (78%), unresectable esophageal cancer (10%) and gastric cancer (6%). There were no conversions to open surgery. The 30-day complication rate was 4.0% and included catheter dislodgement (1%), intraperitoneal catheter displacement (0.7%), catheter blockage (1%) or breakage (0.3%), site infection requiring catheter removal (0.7%) and abdominal wall hematoma (0.3%). The late complication rate was 8.7% and included jejuno-cutaneous fistula (3.7%), jejunostomy tube dislodgement (3.3%), broken or clogged J-tube (1.3%) and small bowel obstruction (0.3%). The 30-day mortality was 0.3% for a patient with stage IV esophageal cancer who died in the postoperative period secondary to respiratory failure. CONCLUSION: In this large consecutive series of feeding jejunostomy, the laparoscopic approach is feasible and safe and associated with a low rate of small bowel obstruction and no intraabdominal catheter-related infection.
BACKGROUND: Jejunostomy catheters for jejunal feeding are an effective method to improve nutritional status in malnourish patients. However, this procedure is commonly being performed using an open approach, which can be associated with more postoperative pain and prolonged recovery. The objective of this study was to assess the outcomes of patients who underwent placement of feeding jejunostomy using a laparoscopic approach. METHODS: A retrospective review was performed of patients who underwent laparoscopic jejunostomy tube placement between 1998 and 2014. Main outcome measures included indication for catheter placement, rate of conversion rate to open surgery, perioperative and late morbidity and in-hospital mortality. RESULTS: Two hundred and ninety-nine consecutive patients underwent laparoscopic jejunostomy during the study period. The mean age was 64 years, and 81% of patients were male. The mean BMI was 26.2 kg/m(2). The most common indications for catheter placement were resectable esophageal cancer (78%), unresectable esophageal cancer (10%) and gastric cancer (6%). There were no conversions to open surgery. The 30-day complication rate was 4.0% and included catheter dislodgement (1%), intraperitoneal catheter displacement (0.7%), catheter blockage (1%) or breakage (0.3%), site infection requiring catheter removal (0.7%) and abdominal wall hematoma (0.3%). The late complication rate was 8.7% and included jejuno-cutaneous fistula (3.7%), jejunostomy tube dislodgement (3.3%), broken or clogged J-tube (1.3%) and small bowel obstruction (0.3%). The 30-day mortality was 0.3% for a patient with stage IV esophageal cancer who died in the postoperative period secondary to respiratory failure. CONCLUSION: In this large consecutive series of feeding jejunostomy, the laparoscopic approach is feasible and safe and associated with a low rate of small bowel obstruction and no intraabdominal catheter-related infection.
Authors: Luiz Gonzaga Torres Júnior; Fernando Augusto de Vasconcellos Santos; Maria Isabel Toulson Davisson Correia Journal: World J Surg Date: 2014-09 Impact factor: 3.352
Authors: Emily A Speer; Simon C Chow; Christy M Dunst; Amber L Shada; Valerie Halpin; Kevin M Reavis; Maria Cassera; Lee L Swanström Journal: J Gastrointest Surg Date: 2016-02-19 Impact factor: 3.452
Authors: Rashmi R Singh; Simon Eaton; Derek J Roebuck; Alex M Barnacle; Samantha Chippington; Kate M K Cross; Paolo De Coppi; Joe I Curry Journal: Pediatr Surg Int Date: 2018-07-16 Impact factor: 1.827