Button-Loop Feeding Jejunostomy

Ruiz-Elizalde, Alejandro; Frischer, Jason S.; Cowles, Robert A.

doi:10.1007/s11605-008-0708-3

Cited by 16 publications

(6 citation statements)

References 10 publications

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“…Impaired respiratory function as a result of postoperative enteral feeding has also been described [10]. A number of techniques and strategies for catheter placement have been offered [6,8,[11][12][13]. The present study focuses on the safety, efficacy, and utility of jejunostomy tube feeding during the postoperative period in terms of achieving nutritional goals and avoiding gastrointestinal and mechanical complications in patients undergoing esophagectomy.…”

Section: Introductionmentioning

confidence: 96%

Benefits Versus Risks: A Prospective Audit

Gupta

2009

World j. surg.

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Tube jejunostomy feeding is an effective method for providing nutritional support in patients undergoing esophagectomy, and it allows home support for the subset who fail to thrive. Prolonged tube feeding was continued in patients developing anastomotic disruptions and postoperative complications. Feeding jejunostomy has a definitive role to play in the management of the patients undergoing esophagectomy.

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Section: Introductionmentioning

confidence: 96%

Benefits Versus Risks: A Prospective Audit

Gupta

2009

World j. surg.

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“…Button jejunostomy is a novel jejunostomy creation technique rst reported in 1989. [7][8][9][10] There are some advantages of the button jejunostomy, including the simplicity of the procedure, ease of replacement, low risk of tube deviations and obstructions, patient's esthetic outcomes, and a high quality of life. However, a common complication is REF after button jejunostomy removal.…”

Section: Discussionmentioning

confidence: 99%

“…Button jejunostomy has cosmetic advantages and employs an easily replaceable feeding button compared with the conventional Witzel jejunostomy. [7,8] Conversely, it has been reported that refractory enterocutaneous stulas (REFs) are more common after removal of button jejunostomy than Witzel jejunostomy. [9] Few studies reported the risk factors of REFs after button jejunostomy removal.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for refractory enterocutaneous fistula following button jejunostomy removal and its treatment using a novel extraperitoneal approach in patients with esophageal cancer: A retrospective cohort study

Kamada

Ohdaira

Nakashima

et al. 2022

Preprint

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BackgroundEnterocutaneous fistula after removal of the jejunostomy tube leads to multiple problems, such as cosmetic problems, decreased quality of life, electrolyte imbalances, infectious complications, and increased medical costs. However, the risk factors for refractory enterocutaneous fistula (REF) after button jejunostomy removal remain unclear. Therefore, in this study, we assessed the risk factors for REF after button jejunostomy removal in patients with esophageal cancer and reported the surgical outcomes of the novel extraperitoneal approach (EPA) for REF closure.MethodsThis retrospective cohort study included 47 patients who underwent button jejunostomy removal after esophagectomy for esophageal cancer. We assessed the risk factors for REF in these patients and reported the surgical outcomes of the novel EPA for REF closure at the International University of Health and Welfare Hospital between March 2013 and October 2021. The primary endpoint was defined as the occurrence of REF after removal of the button jejunostomy, which was assessed using a maintained data base. The risk factors and outcomes of the EPA for REF closure were retrospectively analyzed.ResultsREFs occurred in 15 (31.9%) patients. In the univariate analysis, REF was significantly more common in patients with albumin level<4.0 g/dL (p=0.026), duration>12 months for button jejunostomy removal (p=0.003), and with a fistula<15.0 mm (p=0.002). The multivariate analysis revealed that a duration>12 months for button jejunostomy removal (odds ratio [OR]:7.15; 95% confidence interval [CI]: 1.38–36.8; p=0.019), and fistula<15.0 mm (OR: 8.08; 95% CI: 1.50–43.6; p=0.002) were independent risk factors for REF. EPA for REF closure was performed in 15 patients. The technical success rate of EPA was 88.2%. Of the 15 EPA procedures, fistula closure was achieved in 12 (80.0%). The complications of EPA (11.7%) were major leakages (n=3) and for two of them, EPA procedure was reperformed, and closure of the fistula was finally achieved. ConclusionThis study suggested that duration>12 months for button jejunostomy removal and fistula<15.0 mm are the independent risk factors for REF after button jejunostomy removal. EPA for REF closure is a novel, simple, and useful surgical option for patients with REF after esophagectomy.

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“…Button jejunostomy is a novel jejunostomy creation technique first reported in 1989 [ 7 – 10 ]. There are some advantages of the button jejunostomy, including the simplicity of the procedure, ease of replacement, low risk of tube deviations and obstructions, patient’s aesthetic outcomes, and a high quality of life.…”

Section: Discussionmentioning

confidence: 99%

“…Button jejunostomy has cosmetic advantages and employs an easily replaceable feeding button compared with the conventional Witzel jejunostomy [ 7 , 8 ]. Conversely, it has been reported that refractory enterocutaneous fistulas (REFs) are more common after removal of button jejunostomy than Witzel jejunostomy [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for refractory enterocutaneous fistula following button jejunostomy removal and its treatment using a novel extraperitoneal approach in patients with oesophageal cancer: a retrospective cohort study

et al. 2022

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Background Enterocutaneous fistula after removal of the jejunostomy tube leads to multiple problems, such as cosmetic problems, decreased quality of life, electrolyte imbalances, infectious complications, and increased medical costs. However, the risk factors for refractory enterocutaneous fistula (REF) after button jejunostomy removal remain unclear. Therefore, in this study, we assessed the risk factors for REF after button jejunostomy removal in patients with oesophageal cancer and reported the surgical outcomes of the novel extraperitoneal approach (EPA) for REF closure. Methods This retrospective cohort study included 47 patients who underwent button jejunostomy removal after oesophagectomy for oesophageal cancer. We assessed the risk factors for REF in these patients and reported the surgical outcomes of the novel EPA for REF closure at the International University of Health and Welfare Hospital between March 2013 and October 2021. The primary endpoint was defined as the occurrence of REF after removal of the button jejunostomy, which was assessed using a maintained database. The risk factors and outcomes of the EPA for REF closure were retrospectively analysed. Results REFs occurred in 15 (31.9%) patients. In the univariate analysis, REF was significantly more common in patients with albumin level < 4.0 g/dL (p = 0.026), duration > 12 months for button jejunostomy removal (p = 0.003), and with a fistula < 15.0 mm (p = 0.002). The multivariate analysis revealed that a duration > 12 months for button jejunostomy removal (odds ratio [OR]: 7.15; 95% confidence interval [CI]: 1.38–36.8; p = 0.019) and fistula < 15.0 mm (OR: 8.08; 95% CI: 1.50–43.6; p = 0.002) were independent risk factors for REF. EPA for REF closure was performed in 15 patients. The technical success rate of EPA was 88.2%. Of the 15 EPA procedures, fistula closure was achieved in 12 (80.0%). The complications of EPA (11.7%) were major leakages (n = 3) and for two of them, EPA procedure was re-performed, and closure of the fistula was finally achieved. Conclusion This study suggested that duration > 12 months for button jejunostomy removal and fistula < 15.0 mm are the independent risk factors for REF after button jejunostomy removal. EPA for REF closure is a novel, simple, and useful surgical option for patients with REF after oesophagectomy.

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Button-Loop Feeding Jejunostomy

Abstract: We present a simple and efficient jejunostomy technique that does not require a sewn anastomosis and employs an easily exchangeable feeding button.

Cited by 16 publications

References 10 publications

Benefits Versus Risks: A Prospective Audit

Benefits Versus Risks: A Prospective Audit

Risk factors for refractory enterocutaneous fistula following button jejunostomy removal and its treatment using a novel extraperitoneal approach in patients with esophageal cancer: A retrospective cohort study

Risk factors for refractory enterocutaneous fistula following button jejunostomy removal and its treatment using a novel extraperitoneal approach in patients with oesophageal cancer: a retrospective cohort study

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