Jaquet R, Rivkine E, De Souza N, Roudié J. Benefits of jejunostomy feeding in patients who underwent gastrectomy for cancer treatment. World J Gastrointest Surg 2024; 16(8): 2461-2473 [PMID: PMC11362917 DOI: 10.4240/wjgs.v16.i8.2461]
Corresponding Author of This Article
Romain Jaquet, MD, Surgeon, Department of Digestive and Visceral Surgery, Nord Essonne Hospital Group - Longjumeau Site, 159 Rue du President François Mitterrand, Longjumeau 91160, France. romain2025.jaquet@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2024; 16(8): 2461-2473 Published online Aug 27, 2024. doi: 10.4240/wjgs.v16.i8.2461
Benefits of jejunostomy feeding in patients who underwent gastrectomy for cancer treatment
Romain Jaquet, Emmanuel Rivkine, Nicole De Souza, Jean Roudié
Romain Jaquet, Department of Digestive and Visceral Surgery, Nord Essonne Hospital Group - Longjumeau Site, Longjumeau 91160, France
Emmanuel Rivkine, Nicole De Souza, Jean Roudié, Department of General and Digestive Surgery, Pierre Zobda-Quitman Hospital, University Hospital Center, Martinique, France, Fort de France 97261, Martinique
Author contributions: Jaquet R and Roudié J contributed to conception and design; Jaquet R contributed to collection and assembly of data, data analysis and interpretation, manuscript writing; All authors contributed to and final approval of manuscript.
Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki and got the agreement of the Commission Nationale de l’Informatique et des Libertés, No. 2065145 v 0.
Informed consent statement: As a retrospective study, not directly involving humans (MRC004), participants don't require informed consent prior to inclusion in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are not available for confidentiality reasons. The data are not publicly available due to restrictions related to confidentiality/privacy regulations, and institutional policy.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
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: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Romain Jaquet, MD, Surgeon, Department of Digestive and Visceral Surgery, Nord Essonne Hospital Group - Longjumeau Site, 159 Rue du President François Mitterrand, Longjumeau 91160, France. romain2025.jaquet@gmail.com
Received: February 18, 2024 Revised: June 17, 2024 Accepted: July 8, 2024 Published online: August 27, 2024 Processing time: 179 Days and 19.5 Hours
Abstract
BACKGROUND
Gastric cancer is associated with significant undernutrition responsible for an increase in morbidity and mortality after gastrectomy.
AIM
To evaluate the impact of enteral nutrition by jejunostomy feeding in patients undergoing gastrectomy for cancer.
METHODS
Between 2003 and 2017, all patients undergoing gastrectomy for cancer treatment were included retrospectively. A group with jejunostomy (J + group) and a group without jejunostomy (J - group) were compared.
RESULTS
Of the 172 patients included, 60 received jejunostomy. Preoperatively, the two groups were comparable with respect to the nutritional parameters studied (body mass index, albumin, etc.). In the postoperative period, the J + group lost less weight and albumin: 5.74 ± 8.4 vs 9.86 ± 7.5 kg (P = 0.07) and 7.2 ± 5.6 vs 14.7 ± 12.7 g/L (P = 0.16), respectively. Overall morbidity was 25% in the J + group and 36.6% in the J - group (P = 0.12). The J + group had fewer respiratory, infectious, and grade 3 complications: 0% vs 5.4% (P = 0.09), 1.2% vs 9.3% (P = 0.03), and 0% vs 4.7% (P = 0.05), respectively. The 30-day mortality was 6.7% in the J + group and 6.3% in the J - group (P = 0.91).
CONCLUSION
Jejunostomy feeding after gastrectomy improves nutritional characteristics and decreases postoperative morbidity. A prospective study could confirm our results.
Core Tip: Jejunostomy feeding in patients undergoing gastrectomy for cancer significantly improves postoperative nutritional status and reduces complications. A study of 172 patients showed that those with jejunostomy had less weight loss, better albumin levels, and fewer respiratory, infectious, and grade 3 complications compared to those without jejunostomy. Overall morbidity was lower, though 30-day mortality rates were similar between the groups.
