Routine jejunostomy tube feeding following esophagectomy.
Teus J. Weijs,Hanneke W.J. van Eden,Jelle P. Ruurda,Misha D. P. Luyer,Elles Steenhagen,Grard A. P. Nieuwenhuijzen,Richard van Hillegersberg +6 more
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TLDR
Routine discharge with home-tube feeding with emphasis on weight loss, length of stay and re-admissions and the value of routine jejunostomy placement are questioned and emphasize the need for further research.Abstract:
Background: Malnutrition is an important problem following esophagectomy. A surgically placed jejunostomy secures an enteral feeding route, facilitating discharge with home-tube feeding and long-term nutritional support. However, specific complications occur, and data are lacking that support its use over other enteral feeding routes. Therefore routine jejunostomy tube feeding and discharge with home-tube feeding was evaluated, with emphasis on weight loss, length of stay and re-admissions.
Methods: Consecutive patients undergoing esophagectomy for cancer, with gastric tube reconstruction and jejunostomy creation, were analyzed. Two different regimens were compared. Before January 07, 2011 patients were discharged when oral intake was sufficient, without tube feeding. After that discharge with home-tube feeding was routinely performed. Logistic regression analysis corrected for confounders.
Results: Some 236 patients were included. The median duration of tube feeding was 35 days. Reoperation for a jejunostomy-related complication was needed in 2%. The median body mass index (BMI) remained stable during tube feeding. The BMI decreased significantly after stopping tube feeding: from 25.6 (1st–3rd quartile 23.0–28.6) kg/m2 to 24.4 (22.0–27.1) kg/m2 at 30 days later [median weight loss: 3.0 (1.0–5.3) kg; 3.9% (1.5–6.3%)]. Weight loss was not affected by the duration of tube feeding duration. Routine home-tube feeding did not affect weight loss, admission time or the readmission rate. Conclusions: Weight loss following esophagectomy occurs once that tube feeding is stopped, independently from the time interval after esophagectomy. Moreover routine discharge with home-tube feeding does not reduce length of stay or readmissions. These findings question the value of routine jejunostomy placement and emphasize the need for further research.read more
Citations
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Journal ArticleDOI
Complications After Esophagectomy.
TL;DR: This review highlights different approaches in dealing with anastomotic leaks, chyle leaks, cardiopulmonary complications, and later functional issues after esophagectomy.
Journal ArticleDOI
Feeding Jejunostomy after esophagectomy cannot be routinely recommended. Analysis of nutritional benefits and catheter-related complications.
Eduardo Álvarez-Sarrado,Fernando Mingol Navarro,Raquel J. Rosellón,Neus Ballester Pla,Francisco Javier Vaqué Urbaneja,Carmen Muniesa Gallardo,María López Rubio,Eduardo García-Granero Ximénez +7 more
TL;DR: 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.
Journal ArticleDOI
Evaluation of the need for routine feeding jejunostomy for enteral nutrition after esophagectomy
Yuji Akiyama,Takeshi Iwaya,Fumitaka Endo,Haruka Nikai,Kei Sato,Shigeaki Baba,Takehiro Chiba,Toshimoto Kimura,Takeshi Takahara,Hiroyuki Nitta,Koki Otsuka,Masaru Mizuno,Yusuke Kimura,Keisuke Koeda,Akira Sasaki +14 more
TL;DR: The results suggest that routine feeding jejunostomy may not be necessary for all patients undergoing esophagectomy, and there was no increase in postoperative complications (including pneumonia) in the patients who did not receive EN via feeding jeJunostomy.
Journal ArticleDOI
Needle Catheter Jejunostomy in Patients Undergoing Surgery for Upper Gastrointestinal and Pancreato-Biliary Cancer-Impact on Nutritional and Clinical Outcome in the Early and Late Postoperative Period.
TL;DR: In patients with upper gastrointestinal and pancreato-biliary cancer, supplementing enteral nutrition during the postoperative course and continued after discharge may attenuate unavoidable weight loss and a reduction of body cell mass within the first six months.
Journal ArticleDOI
Risk Factors for Weight Loss 1 Year After Esophagectomy and Gastric Pull-up for Esophageal Cancer.
TL;DR: Initial body weight and postoperative VCP were related to weight loss 1 year after esophagectomy and patients with VCP need additional nutritional monitoring and support.
References
More filters
Journal ArticleDOI
The Harris Benedict equation reevaluated: resting energy requirements and the body cell mass.
Allan M. Roza,Harry M. Shizgal +1 more
TL;DR: The Harris Benedict equations accurately predict resting energy expenditure in normally nourished individuals with a precision of +/- 14%, but are unreliable in the malnourished patient.
Journal ArticleDOI
Allowing normal food at will after major upper gastrointestinal surgery does not increase morbidity: a randomized multicenter trial.
Kristoffer Lassen,Jørn Kjaeve,Torunn Fetveit,Gerd Tranø,Helgi Kjartan Sigurdsson,Arild Horn,Arthur Revhaug +6 more
TL;DR: Allowing patients to eat normal food at will from the first day after major upper GI surgery does not increase morbidity compared with traditional care with nil-by-mouth and enteral feeding.
Journal ArticleDOI
Immediate postoperative enteral feeding results in impaired respiratory mechanics and decreased mobility.
TL;DR: Immediate postoperative jejunal feeding was associated with impaired respiratory mechanics and postoperative mobility and did not influence the loss of muscle strength or the increase in fatigue, which occurred after major surgery.
Journal ArticleDOI
Early enteral feeding compared with parenteral nutrition after oesophageal or oesophagogastric resection and reconstruction
S Gabor,Heiko Renner,Veronika Matzi,B. Ratzenhofer,Joerg Lindenmann,Oliver Sankin,Pinter H,Alfred Maier,Josef Smolle,Freyja-Maria Smolle-Jüttner +9 more
TL;DR: Early enteral feeding significantly reduces the duration of ICU treatment and total hospital stay in patients who undergo oesophagectomy or oesphagogastrectomy for Oesophageal carcinoma and if compared to the PF group, EEF patients recovered faster considering theduration of both stay in the ICU and in the hospital.
Journal ArticleDOI
Post-oesophagectomy early enteral nutrition via a needle catheter jejunostomy: 8-year experience at a specialist unit.
TL;DR: NCJ feeding was extremely effective in preventing severe post-operative weight loss in the majority of oesophagectomy patients post-op, but oral intake was generally poor at discharge with only 65% of requirements being met orally.
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