S J Gerndt1, M B Orringer. 1. Department of Surgery, University of Michigan Medical Center, Ann Arbor.
Abstract
BACKGROUND: The safety and efficacy of various methods of accessing the intestinal tract, including needle catheter jejunostomy, have been well described. This review represents an evaluation of the Witzel tube jejunostomy as an adjunct to esophagectomy. METHODS: The records of 523 patients who underwent esophagectomy for benign or malignant disease from 1976 to 1991 were reviewed. Each patient underwent placement of a tube jejunostomy at the time of esophagectomy and esophageal reconstruction. Utilization of the jejunostomy tube and the complications related to its placement were examined. RESULTS: The feeding jejunostomy was used in all patients in the initial postoperative period, for more than 3 weeks in 11%, and for more than 2 months in 6.9%. Major complications related to the jejunostomy tube occurred in 11 patients (2.1%). There were no fatal complications. CONCLUSIONS: Tube jejunostomy is a useful adjunct to esophagectomy for providing enteral nutrition during the postoperative period. The Witzel jejunostomy as described herein is comparable in terms of safety, function, and complication rate to the needle catheter jejunostomy and has certain technical advantages. Routine use of tube jejunostomy is recommended in patients undergoing esophagectomy.
BACKGROUND: The safety and efficacy of various methods of accessing the intestinal tract, including needle catheter jejunostomy, have been well described. This review represents an evaluation of the Witzel tube jejunostomy as an adjunct to esophagectomy. METHODS: The records of 523 patients who underwent esophagectomy for benign or malignant disease from 1976 to 1991 were reviewed. Each patient underwent placement of a tube jejunostomy at the time of esophagectomy and esophageal reconstruction. Utilization of the jejunostomy tube and the complications related to its placement were examined. RESULTS: The feeding jejunostomy was used in all patients in the initial postoperative period, for more than 3 weeks in 11%, and for more than 2 months in 6.9%. Major complications related to the jejunostomy tube occurred in 11 patients (2.1%). There were no fatal complications. CONCLUSIONS: Tube jejunostomy is a useful adjunct to esophagectomy for providing enteral nutrition during the postoperative period. The Witzel jejunostomy as described herein is comparable in terms of safety, function, and complication rate to the needle catheter jejunostomy and has certain technical advantages. Routine use of tube jejunostomy is recommended in patients undergoing esophagectomy.
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