Laparoscopic T-tube feeding jejunostomy as an adjunct to staging laparoscopy for upper gastrointestinal malignancies: the technique and review of outcomes

Siow, Sze Li; Mahendran, Hans Alexander; Wong, Chee Ming; Milaksh, Nirumal Kumar; Nyunt, Myo

doi:10.1186/s12893-017-0221-2

Cited by 26 publications

(13 citation statements)

References 27 publications

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“…Furthermore, the study highlights the risk of major complications among subjects undergoing jejunostomy insertion by laparotomy as a stand-alone procedure. This nding is in keeping with the literature, wherein reported complication rates range widely but reach as much as 37% and beyond in some series [20,21].…”

Section: Discussionsupporting

confidence: 90%

Laparoscopic Versus Open Feeding Jejunostomy Insertion in Oesophagogastric Cancer

Mastoridis

Bracalente

Hanganu

et al. 2020

Preprint

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Background Jejunal feeding is an invaluable method by which to improve the nutritional status of patients undergoing neoadjuvant and surgical treatment of oesophageal malignancies. However, the insertion of a feeding jejunostomy can cause significant postoperative morbidity. The aim of this study is to compare the outcomes of patients undergoing placement of feeding jejunostomy by conventional laparotomy with an alternative laparoscopic approach. Methods A retrospective review of data prospectively collected at the Oxford Oesophagogastric Centre between August 2017 and July 2019 was performed including consecutive patients undergoing feeding jejunostomy insertion. Results In the study period, 157 patients underwent jejunostomy insertion in the context of oesophageal cancer therapy, 126 (80%) by open technique and 31 (20%) laparoscopic. Pre-operative demographic and nutritional characteristics were broadly similar between groups. In the early postoperative period jejunostomy-associated complications were noted in 54 cases (34.4%) and were significantly more common among those undergoing open as compared with laparoscopic insertion (38.1% vs 19.3%, P = 0.049). Furthermore, major complications were more common among those undergoing open insertion, whether as a stand-alone procedure or in conjunction with laparoscopic staging (n = 11/71), as compared with insertion at the time of oesophagectomy (n = 3/86, P = 0.011). Conclusions This report represents the largest to our knowledge single-centre comparison of open versus laparoscopic jejunostomy insertion in patients undergoing oesophagectomy in the treatment of gastroesophageal malignancy. We conclude that the laparoscopic jejunostomy insertion technique described represents a safe and effective approach to enteral access which may offer superior outcomes to conventional open procedures.

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Section: Discussionsupporting

confidence: 90%

Laparoscopic Versus Open Feeding Jejunostomy Insertion in Oesophagogastric Cancer

Mastoridis

Bracalente

Hanganu

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Furthermore, the study highlights the risk of major complications among subjects undergoing jejunostomy insertion as an open stand-alone procedure. This finding is in keeping with the literature, wherein reported complication rates for this approach range widely but can reach 37% and beyond in some series [12,13]. One explanation for the higher rates of complication encountered in stand-alone open insertions is that such procedures are generally performed as 'mini-laparotomies' to avoid the morbidity of larger incisions.…”

Section: Discussionsupporting

confidence: 84%

Laparoscopic vs. open feeding jejunostomy insertion in oesophagogastric cancer

et al. 2021

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Background Jejunal feeding is an invaluable method by which to improve the nutritional status of patients undergoing neoadjuvant and surgical treatment of oesophageal malignancies. However, the insertion of a feeding jejunostomy can cause significant postoperative morbidity. The aim of this study is to compare the outcomes of patients undergoing placement of feeding jejunostomy by conventional laparotomy with an alternative laparoscopic approach. Methods A retrospective review of data prospectively collected at the Oxford Oesophagogastric Centre between August 2017 and July 2019 was performed including consecutive patients undergoing feeding jejunostomy insertion. Results In the study period, 157 patients underwent jejunostomy insertion in the context of oesophageal cancer therapy, 126 (80%) by open technique and 31 (20%) laparoscopic. Pre-operative demographic and nutritional characteristics were broadly similar between groups. In the early postoperative period jejunostomy-associated complications were noted in 54 cases (34.4%) and were significantly more common among those undergoing open as compared with laparoscopic insertion (38.1% vs. 19.3%, P = 0.049). Furthermore, major complications were more common among those undergoing open insertion, whether as a stand-alone or at the time of staging laparoscopy (n = 11/71), as compared with insertion at the time of oesophagectomy (n = 3/86, P = 0.011). Conclusions This report represents the largest to our knowledge single-centre comparison of open vs. laparoscopic jejunostomy insertion in patients undergoing oesophagectomy in the treatment of gastroesophageal malignancy. We conclude that the laparoscopic jejunostomy insertion technique described represents a safe and effective approach to enteral access which may offer superior outcomes to conventional open procedures.

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“…Laparoscopy detected peritoneal metastases in 7 out of the 40 cases (17.5%) none of which were noted on CT scan, avoiding unnecessary laparotomy in these patients (Kandasami, 2012). Siow et al, (2017) have investigated and advocated the placement of a T-tube feeding jejunostomy at the same laparoscopy staging procedure.…”

Section: Assessmentmentioning

confidence: 99%