Complications of Feeding Jejunostomy Tubes in Patients with Gastroesophageal Cancer

• Published in: Journal of gastrointestinal surgery Vol. 21; no. 2; pp. 259 - 265
• Main Authors: Choi, Audrey H., O’Leary, Michael P., Merchant, Shaila J., Sun, Virginia, Chao, Joseph, Raz, Dan J., Kim, Jae Y., Kim, Joseph
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2017; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Enteral Nutrition - methods; Esophageal cancer; Esophageal Neoplasms - surgery; Esophagectomy; Female; Gastrectomy; Gastric cancer; Gastroenterology; Gastrointestinal surgery; Humans; Intubation, Gastrointestinal - adverse effects; Jejunostomy - adverse effects; Laparoscopy; Male; Malnutrition - surgery; Malnutrition - therapy; Medical records; Medicine; Medicine & Public Health; Middle Aged; Nursing; Nutrition; Nutritional Status; Original Article; Ostomy; Patients; Retrospective Studies; Small intestine; Stomach Neoplasms - surgery; Surgery; Young Adult; United States > US; Complications; Gastric cancer; Esophageal cancer; Outcomes; Jejunostomy tube
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-016-3297-6

Background Feeding jejunostomy tubes (FJT) in patients undergoing resection of gastroesophageal cancers facilitate perioperative nutrition. Data regarding FJT use and complications are limited. Study design A single institution review was performed for patients who underwent perioperative FJT placement for gastrectomy or esophagogastrectomy from 2007 to 2015. FJT-related and unrelated complications were evaluated. Results FJTs were inserted for total/completion gastrectomy ( n  = 49/117, 41.9 %), proximal gastrectomy ( n  = 7/117, 6.0 %), or esophagogastrectomy ( n  = 61/117, 52.1 %). Ninety percent ( n  = 106/117) of patients used an FJT at some time point. Although the majority of patients (75.2 %) used FJTs after discharge, 8.5 % ( n  = 10/117) never used the FJT and 10.3 % ( n  = 12/117) used the FJT only during hospitalization. Overall, 44.4 % ( n  = 52/117) had FJT-related complications, including dislodgement ( n  = 22), clogging ( n  = 13), and leakage ( n  = 6). The majority of FJT complications were resolved by telephone triage (13.5 %) or bedside/clinic intervention (57.7 %), but 3.4 % required operative intervention for small bowel obstruction ( n  = 3) and hemorrhage ( n  = 1). FJT complications were more common with gastrectomy than esophagogastrectomy (53.6 vs. 36.0 %), perhaps related to longer FJT use in gastrectomy patients (71 vs. 38 days). Conclusions FJT-related complications are common, occurring more frequently after gastrectomy than esophagogastrectomy. In most patients, complications can be managed by simple measures, rarely requiring operative intervention. Nevertheless, the need for FJTs should be carefully considered to balance nutritional benefits with the risks of insertion and usage.