Feeding Jejunostomy after esophagectomy cannot be routinely recommended. Analysis of nutritional benefits and catheter-related complications - 07/12/18
, Fernando Mingol Navarro b , Raquel J. Rosellón a , Neus Ballester Pla a , Francisco Javier Vaqué Urbaneja b , Carmen Muniesa Gallardo a , María López Rubio a , Eduardo García-Granero Ximénez c Abstract |
Background |
Patients undergoing esophagectomy for cancer usually deal with malnourishment which increases postoperative morbimortality. The objective of this paper is to analyze the nutritional benefits of feeding jejunostomy (FJ) for early postoperative enteral nutrition (EN) and directly-related complications.
Material and methods |
Retrospective study of 100 patients undergoing esophagectomy for cancer between 2008 and 2016.
Results |
FJ was placed in 47 patients. 82.98% reached EN requirements in FJ group, with a median EN re-start of 1.9 days and median days to objective requirements of 5 days.
51.06% developed directly-related FJ complication, 91.66% of them mild ones (gastrointestinal or catheter-related). 2 patients (4.25%) required re-intervention.
No significant differences were shown in total protein and albumin seric levels during first postoperative week and in anastomotic leak rate between both groups (p > 0.05).
Conclusions |
Feeding jejunostomies are associated with a great number of complications although most are not life-threatening. Since its nutritional benefit is not proven FJ cannot routinely recommended after esophagectomy. However, the optimal pathway for EN reintroduction, including direct oral intake, is still a matter of debate.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | Malnourishment is commonly associated with increased postoperative morbi-mortality in esophageal cancer. |
• | No significant differences in nutritional parameters and anastomotic leak rate were shown related to feeding jejunostomy use. |
• | Feeding jejunostomies are associated with a non-negligible number of complications although most are not life-threatening. |
• | Selected patients may benefit from FJ for EN such as those with severe aphagia, BMI<18,5 or undergoing McKeown esophagectomy. |
• | FJ cannot be routinely recommended after esophagectomy for early postoperative EN. |
Mappa
Vol 217 - N° 1
P. 114-120 - gennaio 2019 Ritorno al numero
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