Blakely AM, Ajmal S, Sargent RE, Ng TT, Miner TJ. Critical analysis of feeding jejunostomy following resection of upper gastrointestinal malignancies. World J Gastrointest Surg 2017; 9(2): 53-60 [PMID: 28289510 DOI: 10.4240/wjgs.v9.i2.53]
Corresponding Author of This Article
Thomas J Miner, MD, FACS, Department of Surgery, Rhode Island Hospital, 593 Eddy Street, APC 443, Providence, RI 02903, United States. tminer@usasurg.org
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective 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. Feb 27, 2017; 9(2): 53-60 Published online Feb 27, 2017. doi: 10.4240/wjgs.v9.i2.53
Table 1 Comparison of complications within thirty days by grade n (%)
Complication
Subtotal gastrectomy (n = 63)
Total gastrectomy (n = 42)
Esophagectomy (n = 182)
None
45 (71.4)
20 (47.6)
91 (50.0)
Low-grade
10 (15.9)
4 (9.5)
32 (17.6)
High-grade
8 (12.7)
15 (35.7)
54 (29.7)
Overall mortality
0 (0.0)
3 (7.1)
5 (2.7)
Tube-related complications
0
6
1
Table 2 Clinical characteristics of esophagectomy in relation to tube feed requirement n (%)
Characteristic
Total (n = 182)
Tube feeds used
Tube feeds not used
P value
Age > 65 yr
93
40 (43.0)
53 (57.0)
0.24
Male sex
145
69 (47.6)
76 (52.4)
0.91
Tumor type
Adenocarcinoma
158
76 (48.1)
82 (51.9)
Squamous cell carcinoma
15
7 (46.7)
8 (53.3)
0.99
High-grade dysplasia
8
4 (50.0)
4 (50.0)
Neo-adjuvant therapy
114
52 (45.6)
62 (54.4)
0.54
Post-operative complication
91
66 (72.5)
25 (27.5)
< 0.0001
Esophagectomy approach
Transhiatal
107
64 (59.8)
43 (40.2)
< 0.0001
Ivor-Lewis
56
14 (25.0)
42 (75.0)
Table 3 Tube feed reliance by esophagectomy approach n (%)
Tube feed reliance
Transhiatal (n = 107)
Ivor-lewis (n = 56)
Other (n = 19)
None
43 (40.2)
42 (75.0)
10 (52.6)
Partial
20 (18.7)
10 (17.6)
4 (21.1)
Total
44 (41.1)
4 (7.1)
5 (26.3)
Table 4 Feeding tube placement and utilization and overall need for nutritional support in relation to extent of gastric resection n (%)
Variable
Overall (n = 105)
Subtotal (n = 63)
Total (n = 42)
P value
Feeding tube placed
47 (44.8)
8 (12.7)
39 (92.9)
< 0.0001
Tube placed, utilized
25 (53.2)
5 (62.5)
20 (51.3)
0.71
Tube placed, utilized, PN utilized
5 (10.6)
-
5 (12.8)
0.57
Tube placed, not utilized
22 (46.8)
3 (37.5)
19 (48.7)
0.71
Tube placed, not utilized, PN utilized
6 (12.8)
1 (12.5)
5 (12.8)
1.0
PN utilized
22 (21.0)
11 (17.5)
11 (26.2)
0.28
PN utilized with feeding tube
11 (10.5)
1 (9.1)
10 (90.9)
0.42
PN utilized without feeding tube
11 (10.5)
10 (90.9)
1 (9.1)
0.51
No nutritional support used regardless of feeding tube placement
63 (60.0)
47 (74.6)
16 (38.1)
0.0004
Citation: Blakely AM, Ajmal S, Sargent RE, Ng TT, Miner TJ. Critical analysis of feeding jejunostomy following resection of upper gastrointestinal malignancies. World J Gastrointest Surg 2017; 9(2): 53-60