Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2022; 14(10): 616-627
Published online Oct 16, 2022. doi: 10.4253/wjge.v14.i10.616
Laparoscopic Janeway gastrostomy as preferred enteral access in specific patient populations: A systematic review and case series
Max Murray-Ramcharan, Maria Camilla Fonseca Mora, Federico Gattorno, Javier Andrade
Max Murray-Ramcharan, Department of General Surgery, Harlem Hospital Center, Harlem, NY 10037, United States
Maria Camilla Fonseca Mora, Department of Medicine, NYU Langone Medical Center-Woodhull Medical Center, Brooklyn, NY 11206, United States
Federico Gattorno, Javier Andrade, Department of Surgery, NYU Langone Medical Center-Woodhull Medical Center, Brooklyn, NY 11206, United States
Author contributions: Murray-Ramcharan M conceptualized research study and both Murray-Ramcharan M and Fonseca Mora M designed the research study; Murray-Ramcharan M and Fonseca Mora M performed the research; Gattorno F and Andrade J contributed analytic tools and editing; Murray-Ramcharan M and Fonseca Mora M analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Max Murray-Ramcharan, MD, Doctor, Department of General Surgery, Harlem Hospital Center, 506 Lenox Avenue, Harlem, NY 10037, United States.
Received: June 6, 2022
Peer-review started: June 6, 2022
First decision: August 1, 2022
Revised: August 5, 2022
Accepted: October 4, 2022
Article in press: October 4, 2022
Published online: October 16, 2022
Research background

LJG, when initially described, was used as one of the first-line enteral access options, and has since been replaced by the advent and popularity of PEG. The significance of this study is that it demonstrates that the laparoscopic modification may be an acceptable first-line procedure for specific indications due to its longevity and ease of completion.

Research motivation

The main topics of this paper are that LJG may have more clinical relevance than previously considered. The problems this paper addresses is the complication rate including those caused due to dislodgement and tube removal with the PEG procedure. This procedure ameliorates these complications and may have a role in first-line access for specific indications.

Research objectives

The main objectives of this project was to describe cases of LJG as well as perform a systematic review of the available data as it relates to LJG for enteral access. We realized from this review, that LJG may serve as a viable alternative to PEG as a first-line option for enteral access in specific populations. The significance of this realization can result in lower morbidity and mortality as it relates to the complications of PEG dislodgements in specific patient populations.

Research methods

A systematic review was performed of all available data of LJG relating to use for enteral access. This data was analyzed by the reviewers to realize the objectives. To our knowledge, no large systematic reviews of LJG have been recently performed for this purpose.

Research results

Our findings describe relatively low rate of complications from LJG, largely as a result of the permanent gastrostomy tube formed in the procedure. We also note significant technical ease in completion of the procedure.

Research conclusions

This study proposes that LJG may be a viable alternative to PEG as a first-line procedure in specific patient populations.

This study describes the laparoscopic modification of Janeway gastrostomy and notes the technical ease and reproducibility.

Research perspectives

The direction for future research in this topic may include prospective studies and randomized controlled trials to determine true comparative data between LJG and PEG and other gastrostomy alternatives, and also to provide objective data to guide optimal patient selection.