Randomized Clinical Trial: Nasoenteric Tube or Jejunostomy as a Route for Nutrition After Major Upper Gastrointestinal Operations

Júnior, Luiz Gonzaga Torres; Santos, Fernando Augusto de Vasconcellos; Correia, María Isabel Toulson Davisson

doi:10.1007/s00268-014-2589-9

Cited by 26 publications

(22 citation statements)

References 39 publications

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“…A randomized clinical study that compared nasoenteric tubes to jejunostomy feeding in upper gastrointestinal tract cancer patients showed that the length of enteral feeding use was less in the nasoenteric group and parenteral feeding was required more frequently than in jejunostomy feeding group. Complications related to the different feeding routes were similar between the two groups [94]. A recent review investigated the best route for enteral nutrition following esophagectomy (oral intake, jejunostomy, or nasojejunal tube feeding) in terms of postoperative complication rates, percentage of patients meeting their nutritional needs, weight loss, tube feeding complications, mortality, patient satisfaction, and length of hospital stay.…”

Section: Type Of Feedingmentioning

confidence: 97%

Nutritional Management of Esophageal Cancer Patients

Schizas¹,

Lidoriki²,

Moris³

et al. 2017

Esophageal Abnormalities

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Esophageal cancer is associated with malnutrition in the vast majority of patients. This phenomenon is partly attributed to the disease process itself, the location of the tumor and other factors, such as dysphagia which is often accentuated due to chemotherapy/ radiotherapy treatment or surgical intervention. The poor nutritional status of these patients is often related to the presence of cancer cachexia, altered metabolism, and tissue wasting. Malnutrition in this patient population affects quality of life, worsens patient's tolerance to chemotherapy and accounts for lower survival. Nutritional management of these patients includes both proper nutritional assessment and support and might prevent, to a certain extent, the manifestation of malnutrition-related consequences. The purpose of this article is to review the current literature in order to focus on the etiology and diagnosis of malnutrition in esophageal cancer patients, emphasizing also on the optimal nutritional support during multimodality treatment.

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Section: Type Of Feedingmentioning

confidence: 97%

Nutritional Management of Esophageal Cancer Patients

Schizas¹,

Lidoriki²,

Moris³

et al. 2017

Esophageal Abnormalities

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“…3 Both routes were associated with a similar number of complications and a similar LOS. Nevertheless, the JT route allowed EN for longer periods.…”

Section: Discussionmentioning

confidence: 95%

“…Table 3 summarises studies on EN after oesophagectomy. 3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Although the use of EN is not without its disadvantages, the benefits outweigh the risks. Early EN was compared with delayed nutrition by Wang et al, and was found to be associated with a short LOS, fewer incidences of pneumonia and better nutrition outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Early enteral nutrition (EN) was therefore advocated to improve nutritional outcomes and decrease the incidence of postoperative complications. 3 Early EN has been found to decrease the length of hospital stay (LOS) and lead to a better outcome than parenteral nutrition (PN), in addition to reducing the total cost of patient care. 4,5 Early EN following oesophagectomy is usually maintained via a nasojejunal tube (NJT), a jejunostomy tube (JT) or a pharyngostomy tube (PT).…”

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confidence: 99%

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Routes of early enteral nutrition following oesophagectomy

Elshaer

Gravante

White

et al. 2016

annals

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INTRODUCTION Oesophagectomy for cancer is a challenging procedure with a five-year overall survival rate of 15-20%. Early enteral nutrition following oesophagectomy is a crucial component of the postoperative recovery and carries a significant impact on the outcome. Different methods of enteral feeding were conducted in our unit. The aim of this study was to examine the efficacy and safety of nasojejunal tube (NJT), jejunostomy tube (JT) and pharyngostomy tube (PT) feeding after oesophagectomy. METHODS A retrospective review was carried out of prospectively collected data on patients with oesophageal cancer who underwent an oesophagectomy between 2011 and 2014. The primary outcome was feeding tube related complications such as occlusion, dislocation and leak. The secondary outcomes were length of stay and 30-day morbidity. RESULTS A total of 90 oesophagectomies were included in the study. A NJT was inserted in 41 patients (45.6%), a JT was used in 14 patients (15.5%) and a PT was the route for enteral nutrition in 35 patients (38.9%). In total, five patients (5.5%) developed tube related complications. There were no tube related complications in the NJT group but one JT patient (7.1%) developed tube related cellulitis (p=0.189) and four PT patients (11.4%) developed tube related haemorrhage (p=0.544), tube dislocation (p=0.544) or cellulitis (p=0.189). The median length of stay and 30-day postoperative morbidity were similar between the groups. CONCLUSIONS NJT feeding is a less invasive, feasible route for early enteral nutrition following oesophagectomy. A randomised controlled trial is recommended to verify these findings.

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“…[19] pointed out that a jejunostomy allows enteral therapy for longer periods, especially in patients with complications. In our cases 3 and 4, progressive increase of caloric intake could be smoothly performed through the feeding jejunostomy tube from the day after onset of anastomotic failure.…”

Section: Discussionmentioning

confidence: 99%

The Role of Nutritional Management in the Clinical Course of Severe Complications Associated with the Pancreas after Abdominal Surgery: Presentation of Four Cases

Yukitoshi¹,

Mishima²,

Azuma³

et al. 2014

JACCOA

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Background: All surgeons should note that complications associated with the pancreas after abdominal surgery can be severe and can induce life-threatening problems such as sepsis, abdominal abscess, and intra-abdominal hemorrhage. In such situations, nutritional management is a key element of therapy to achieve a favorable clinical course. Methods:We reviewed the clinical course of four patients with complications associated with the pancreas after abdominal surgery from

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Randomized Clinical Trial: Nasoenteric Tube or Jejunostomy as a Route for Nutrition After Major Upper Gastrointestinal Operations

Abstract: The two enteral routes were associated with the same number of complications. However, the presence of a jejunostomy allowed enteral therapy for longer periods, especially in patients with complications, thus avoiding the need for parenteral nutrition.

Cited by 26 publications

References 39 publications

Nutritional Management of Esophageal Cancer Patients

Nutritional Management of Esophageal Cancer Patients

Routes of early enteral nutrition following oesophagectomy

The Role of Nutritional Management in the Clinical Course of Severe Complications Associated with the Pancreas after Abdominal Surgery: Presentation of Four Cases

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