Feeding Jejunostomy after esophagectomy cannot be routinely recommended. Analysis of nutritional benefits and catheter-related complications.

Autor: Álvarez-Sarrado E; General Surgery Service, University and Polytechnic La Fe Hospital, Av. Fernando Abril, Martorell, 106, 46026, Valencia, Spain. Electronic address: eduardoalvarezsarrado@gmail.com., Mingol Navarro F; Esophago-gastric Surgery Unit, University and Polytechnic La Fe Hospital, Av. Fernando Abril Martorell, 106, 46026, Valencia, Spain. Electronic address: mingolnavarro_6@hotmail.com., J Rosellón R; General Surgery Service, University and Polytechnic La Fe Hospital, Av. Fernando Abril, Martorell, 106, 46026, Valencia, Spain. Electronic address: raqueljrosellon@gmail.com., Ballester Pla N; General Surgery Service, University and Polytechnic La Fe Hospital, Av. Fernando Abril, Martorell, 106, 46026, Valencia, Spain. Electronic address: ballesterplaneus@gmail.com., Vaqué Urbaneja FJ; Esophago-gastric Surgery Unit, University and Polytechnic La Fe Hospital, Av. Fernando Abril Martorell, 106, 46026, Valencia, Spain. Electronic address: vaque_jav@gva.es., Muniesa Gallardo C; General Surgery Service, University and Polytechnic La Fe Hospital, Av. Fernando Abril, Martorell, 106, 46026, Valencia, Spain. Electronic address: mcarmenmuniesag@gmail.com., López Rubio M; General Surgery Service, University and Polytechnic La Fe Hospital, Av. Fernando Abril, Martorell, 106, 46026, Valencia, Spain. Electronic address: maria_1989_pal@hotmail.com., García-Granero Ximénez E; Head of General Surgery Service, University and Polytechnic La Fe Hospital, Av. Fernando Abril Martorell, 106, 46026, Valencia, Spain. Electronic address: eggranero@telefonica.net.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2019 Jan; Vol. 217 (1), pp. 114-120. Date of Electronic Publication: 2018 Oct 01.
DOI: 10.1016/j.amjsurg.2018.08.027
Abstrakt: 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.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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