Emily A Speer1, Simon C Chow2, Christy M Dunst3,4,5, Amber L Shada1, Valerie Halpin2, Kevin M Reavis1,6,7, Maria Cassera1,6,7, Lee L Swanström1,2,6,7,8. 1. Department of Surgery, Providence Portland Medical Center, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA. 2. Department of Surgery, Legacy Good Samaritan Hospital, 1040 NW 22nd Ave, Suite 520, Portland, OR, 97210, USA. 3. Department of Surgery, Providence Portland Medical Center, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA. cdunst@orclinic.com. 4. Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA. cdunst@orclinic.com. 5. Foundation for Surgical Innovation and Education, 4805 NE Glisan St., Suite 6N60, Portland, OR, 97213, USA. cdunst@orclinic.com. 6. Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA. 7. Foundation for Surgical Innovation and Education, 4805 NE Glisan St., Suite 6N60, Portland, OR, 97213, USA. 8. Institut Hospitalo Universitaire Strasbourg, 1, Place de l'Hôpital, 97000, Strasbourg, France.
Abstract
INTRODUCTION: Feeding jejunostomies (J tubes) provide enteral nutrition when oral and gastric routes are not options. Despite their prevalence, there is a paucity of literature regarding their efficacy and clinical burden. METHODS: All laparoscopic J tubes placed over a 5-year period were retrospectively reviewed. Clinical burden was measured by number of clinical contact events (tube-related clinic visits, phone calls, ED visits) and morbidity (dislodgement, clogging, tube fracture, infection, other). Tube replacements were also recorded. RESULTS: One hundred fifty-one patients were included. Fifty-nine percent had associated malignancy, and 35 % were placed for nutritional prophylaxis. Mean time to J tube removal was 146 days. J tubes were expected to be temporary in >90 % but only 50 % had sufficient oral intake for removal. Tubes were removed prematurely due to patient intolerance in 8 %. Mortality was 0 %. Morbidity was 51 % and included clogging (12 %), tube fracture (16 %), dislodgement (25 %), infection (18 %) and "other" (leaking, erosion, etc.) in 17 %. The median number of adverse events per J tube was 2(0-8). Mean number of clinic phone calls was 2.5(0-22), ED visits 0.5(0-7), and clinic visits 1.4(0-13), with 82 % requiring more than one J tube-related clinic visit. Unplanned replacements occurred in 40 %. CONCLUSION: While necessary for some patients, J tubes are associated with high clinical burden.
INTRODUCTION: Feeding jejunostomies (J tubes) provide enteral nutrition when oral and gastric routes are not options. Despite their prevalence, there is a paucity of literature regarding their efficacy and clinical burden. METHODS: All laparoscopic J tubes placed over a 5-year period were retrospectively reviewed. Clinical burden was measured by number of clinical contact events (tube-related clinic visits, phone calls, ED visits) and morbidity (dislodgement, clogging, tube fracture, infection, other). Tube replacements were also recorded. RESULTS: One hundred fifty-one patients were included. Fifty-nine percent had associated malignancy, and 35 % were placed for nutritional prophylaxis. Mean time to J tube removal was 146 days. J tubes were expected to be temporary in >90 % but only 50 % had sufficient oral intake for removal. Tubes were removed prematurely due to patient intolerance in 8 %. Mortality was 0 %. Morbidity was 51 % and included clogging (12 %), tube fracture (16 %), dislodgement (25 %), infection (18 %) and "other" (leaking, erosion, etc.) in 17 %. The median number of adverse events per J tube was 2(0-8). Mean number of clinic phone calls was 2.5(0-22), ED visits 0.5(0-7), and clinic visits 1.4(0-13), with 82 % requiring more than one J tube-related clinic visit. Unplanned replacements occurred in 40 %. CONCLUSION: While necessary for some patients, J tubes are associated with high clinical burden.
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