Feeding jejunostomy following esophagectomy may increase the occurrence of postoperative small bowel obstruction
This study aimed to clarify the characteristics and treatment of bowel obstruction associated with feeding jejunostomy in patients who underwent esophagectomy for esophageal cancer. In this single-center retrospective study, 363 patients underwent esophagectomy with mediastinal lymph node dissection...
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| Veröffentlicht in: | Medicine (Baltimore) 2022-09, Vol.101 (37), p.e30746-e30746 |
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| creator | Nakai, Tomoki Kitadani, Junya Ojima, Toshiyasu Hayata, Keiji Katsuda, Masahiro Goda, Taro Takeuchi, Akihiro Tominaga, Shinta Fukuda, Naoki Nagano, Shotaro Yamaue, Hiroki |
| description | This study aimed to clarify the characteristics and treatment of bowel obstruction associated with feeding jejunostomy in patients who underwent esophagectomy for esophageal cancer. In this single-center retrospective study, 363 patients underwent esophagectomy with mediastinal lymph node dissection for esophageal cancer at the Wakayama Medical University Hospital between January 2014 and June 2021. All patients who underwent esophagectomy routinely underwent feeding jejunostomy or gastrostomy. Feeding jejunostomy was used in the cases of gastric tube reconstruction through the posterior mediastinal route or colon reconstruction, while feeding gastrostomy was used in cases of retrosternal route gastric tube reconstruction. Nasogastric feeding tubes and round ligament technique were not used. Postoperative small bowel obstruction occurred in 19 of 197 cases of posterior mediastinal route reconstruction (9.6%), but in no cases of retrosternal route reconstruction because of the feeding gastrostomy (P |
| doi_str_mv | 10.1097/MD.0000000000030746 |
| format | Article |
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In this single-center retrospective study, 363 patients underwent esophagectomy with mediastinal lymph node dissection for esophageal cancer at the Wakayama Medical University Hospital between January 2014 and June 2021. All patients who underwent esophagectomy routinely underwent feeding jejunostomy or gastrostomy. Feeding jejunostomy was used in the cases of gastric tube reconstruction through the posterior mediastinal route or colon reconstruction, while feeding gastrostomy was used in cases of retrosternal route gastric tube reconstruction. Nasogastric feeding tubes and round ligament technique were not used. Postoperative small bowel obstruction occurred in 19 of 197 cases of posterior mediastinal route reconstruction (9.6%), but in no cases of retrosternal route reconstruction because of the feeding gastrostomy (P < .0001). Of the 19 patients who had bowel obstruction after feeding jejunostomy, 10 patients underwent reoperation (53%) and the remaining 9 patients had conservative treatment (47%). The cumulative incidence of bowel obstruction after feeding jejunostomy was 6.7% at 1 year and 8.7% at 2 years. Feeding jejunostomy following esophagectomy is a risk factor for small bowel obstruction. We recommend feeding gastrostomy inserted from the antrum to the jejunum in the cases of gastric tube reconstruction through the retrosternal route or nasogastric feeding tube in the cases of reconstruction through the posterior mediastinal route.</description><identifier>ISSN: 1536-5964</identifier><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000030746</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Observational Study</subject><ispartof>Medicine (Baltimore), 2022-09, Vol.101 (37), p.e30746-e30746</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>Copyright © 2022 the Author(s). 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In this single-center retrospective study, 363 patients underwent esophagectomy with mediastinal lymph node dissection for esophageal cancer at the Wakayama Medical University Hospital between January 2014 and June 2021. All patients who underwent esophagectomy routinely underwent feeding jejunostomy or gastrostomy. Feeding jejunostomy was used in the cases of gastric tube reconstruction through the posterior mediastinal route or colon reconstruction, while feeding gastrostomy was used in cases of retrosternal route gastric tube reconstruction. Nasogastric feeding tubes and round ligament technique were not used. Postoperative small bowel obstruction occurred in 19 of 197 cases of posterior mediastinal route reconstruction (9.6%), but in no cases of retrosternal route reconstruction because of the feeding gastrostomy (P < .0001). Of the 19 patients who had bowel obstruction after feeding jejunostomy, 10 patients underwent reoperation (53%) and the remaining 9 patients had conservative treatment (47%). The cumulative incidence of bowel obstruction after feeding jejunostomy was 6.7% at 1 year and 8.7% at 2 years. Feeding jejunostomy following esophagectomy is a risk factor for small bowel obstruction. We recommend feeding gastrostomy inserted from the antrum to the jejunum in the cases of gastric tube reconstruction through the retrosternal route or nasogastric feeding tube in the cases of reconstruction through the posterior mediastinal route.</description><subject>Observational Study</subject><issn>1536-5964</issn><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNpdUUtP3DAQjiqQSml_QS8-9hLwK3FyqYSgPCQQl3K2Js54k60TB9thtf-eLIvKYy7zaeZ7aDRZ9pPRE0ZrdXp3cULfSlAlyy_ZEStEmRd1KQ_e4a_ZtxjXlDKhuDzKpkvEth9XZI3refQx-WFLrHfOb3ZTjH7qYIXmZT7AlvSjCQgRSeqQeGPmEHA0C7Rk2sknDJD6JyRxAOdI4zfoiG9iCrNJvR-_Z4cWXMQfr_04e7j88_f8Or-9v7o5P7vNjZRC5SUVDAxYKttKsLIpaisE2raWljNWtaKupeIVQEG5taqgrFkuN4UCBN6aVhxnv_e-09wM2BocUwCnp9APELbaQ68_bsa-0yv_pBffipd8Mfj1ahD844wx6aGPBp2DEf0cNVespFXFJFuoYk81wccY0P6PYVTvHqTvLvTnBy0quVdtvEsY4j83bzDoDsGl7oVeqJrnnHJO6yUr3ymVeAZxO5c2</recordid><startdate>20220916</startdate><enddate>20220916</enddate><creator>Nakai, Tomoki</creator><creator>Kitadani, Junya</creator><creator>Ojima, Toshiyasu</creator><creator>Hayata, Keiji</creator><creator>Katsuda, Masahiro</creator><creator>Goda, Taro</creator><creator>Takeuchi, Akihiro</creator><creator>Tominaga, Shinta</creator><creator>Fukuda, Naoki</creator><creator>Nagano, Shotaro</creator><creator>Yamaue, Hiroki</creator><general>Lippincott Williams & Wilkins</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4958-9525</orcidid></search><sort><creationdate>20220916</creationdate><title>Feeding jejunostomy following esophagectomy may increase the occurrence of postoperative small bowel obstruction</title><author>Nakai, Tomoki ; Kitadani, Junya ; Ojima, Toshiyasu ; Hayata, Keiji ; Katsuda, Masahiro ; Goda, Taro ; Takeuchi, Akihiro ; Tominaga, Shinta ; Fukuda, Naoki ; Nagano, Shotaro ; Yamaue, Hiroki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4437-6031acaf04d8316b59f33efd94f2118d3994728aa502ff7501b000c57aea2dcd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Observational Study</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakai, Tomoki</creatorcontrib><creatorcontrib>Kitadani, Junya</creatorcontrib><creatorcontrib>Ojima, Toshiyasu</creatorcontrib><creatorcontrib>Hayata, Keiji</creatorcontrib><creatorcontrib>Katsuda, Masahiro</creatorcontrib><creatorcontrib>Goda, Taro</creatorcontrib><creatorcontrib>Takeuchi, Akihiro</creatorcontrib><creatorcontrib>Tominaga, Shinta</creatorcontrib><creatorcontrib>Fukuda, Naoki</creatorcontrib><creatorcontrib>Nagano, Shotaro</creatorcontrib><creatorcontrib>Yamaue, Hiroki</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakai, Tomoki</au><au>Kitadani, Junya</au><au>Ojima, Toshiyasu</au><au>Hayata, Keiji</au><au>Katsuda, Masahiro</au><au>Goda, Taro</au><au>Takeuchi, Akihiro</au><au>Tominaga, Shinta</au><au>Fukuda, Naoki</au><au>Nagano, Shotaro</au><au>Yamaue, Hiroki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feeding jejunostomy following esophagectomy may increase the occurrence of postoperative small bowel obstruction</atitle><jtitle>Medicine (Baltimore)</jtitle><date>2022-09-16</date><risdate>2022</risdate><volume>101</volume><issue>37</issue><spage>e30746</spage><epage>e30746</epage><pages>e30746-e30746</pages><issn>1536-5964</issn><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>This study aimed to clarify the characteristics and treatment of bowel obstruction associated with feeding jejunostomy in patients who underwent esophagectomy for esophageal cancer. In this single-center retrospective study, 363 patients underwent esophagectomy with mediastinal lymph node dissection for esophageal cancer at the Wakayama Medical University Hospital between January 2014 and June 2021. All patients who underwent esophagectomy routinely underwent feeding jejunostomy or gastrostomy. Feeding jejunostomy was used in the cases of gastric tube reconstruction through the posterior mediastinal route or colon reconstruction, while feeding gastrostomy was used in cases of retrosternal route gastric tube reconstruction. Nasogastric feeding tubes and round ligament technique were not used. Postoperative small bowel obstruction occurred in 19 of 197 cases of posterior mediastinal route reconstruction (9.6%), but in no cases of retrosternal route reconstruction because of the feeding gastrostomy (P < .0001). Of the 19 patients who had bowel obstruction after feeding jejunostomy, 10 patients underwent reoperation (53%) and the remaining 9 patients had conservative treatment (47%). The cumulative incidence of bowel obstruction after feeding jejunostomy was 6.7% at 1 year and 8.7% at 2 years. Feeding jejunostomy following esophagectomy is a risk factor for small bowel obstruction. We recommend feeding gastrostomy inserted from the antrum to the jejunum in the cases of gastric tube reconstruction through the retrosternal route or nasogastric feeding tube in the cases of reconstruction through the posterior mediastinal route.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><doi>10.1097/MD.0000000000030746</doi><orcidid>https://orcid.org/0000-0003-4958-9525</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Wolters Kluwer Open Health; IngentaConnect Free/Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Observational Study |
| title | Feeding jejunostomy following esophagectomy may increase the occurrence of postoperative small bowel obstruction |
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