Feeding Jejunostomy after esophagectomy cannot be routinely recommended. Analysis of nutritional benefits and catheter-related complications

Autores de IIS La Fe

• Eduardo Álvarez Sarrado

  Autor

• Fernando Mingol Navarro

  Autor

• Raquel J. Rosellón

  Autor

• Maria Neus Ballester Pla

  Autor

• Francisco Javier Vaque Urbaneja

  Autor

• Maria Del Carmen Muniesa Gallardo

  Autor

• María López Rubio

  Autor

• Eduardo García-Granero Ximénez

  Autor

Grupos

• Cirugía digestiva y Cuidados perioperatorios

Abstract

Background: Patients undergoing esophagectomy for cancer usually deal with malnourishment which increases postoperative morbimortality. The objective of this paper is to analyze the nutritional benefits of feeding jejunostomy (FJ) for early postoperative enteral nutrition (EN) and directly-related complications. Material and methods: Retrospective study of 100 patients undergoing esophagectomy for cancer between 2008 and 2016. Results: FJ was placed in 47 patients. 82.98% reached EN requirements in FJ group, with a median EN restart of 1.9 days and median days to objective requirements of 5 days. 51.06% developed directly-related FJ complication, 91.66% of them mild ones (gastrointestinal or catheter-related). 2 patients (4.25%) required re-intervention. No significant differences were shown in total protein and albumin seric levels during first postoperative week and in anastomotic leak rate between both groups (p > 0.05). Conclusions: Feeding jejunostomies are associated with a great number of complications although most are not life-threatening. 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. (C) 2018 Elsevier Inc. All rights reserved.