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Feeding Jejunostomy after esophagectomy cannot be routinely recommended. Analysis of nutritional benefits and catheter-related complications
Authors: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
Affiliation:1. General Surgery Service, University and Polytechnic La Fe Hospital, Av. Fernando Abril, Martorell, 106, 46026, Valencia, Spain;2. Esophago-gastric Surgery Unit, University and Polytechnic La Fe Hospital, Av. Fernando Abril Martorell, 106, 46026, Valencia, Spain;3. Head of General Surgery Service, University and Polytechnic La Fe Hospital, Av. Fernando Abril Martorell, 106, 46026, Valencia, Spain
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 re-start 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.
Keywords:Corresponding author. General Surgery Service   Tower G   5th floor. Administrative area   University and Polytechnic La Fe Hospital   Av. Fernando Abril Martorell   106   46026   Valencia   Spain.
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