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Tsai HI, Chou TC, Yu MC, Yeh CN, Peng MT, Hsieh CH, Su PJ, Wu CE, Kuo YC, Chiu CC, Lee CW. Purely laparoscopic feeding jejunostomy: a procedure which deserves more attention. BMC Surg 2021; 21:37. [PMID: 33441134 PMCID: PMC7805100 DOI: 10.1186/s12893-021-01050-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/04/2021] [Indexed: 01/17/2023] Open
Abstract
Background Laparoscopic procedure has inherent merits of smaller incisions, better cosmesis, less postoperative pain, and earlier recovery. In the current study, we presented our method of purely laparoscopic feeding jejunostomy and compared its results with that of conventional open approach. Methods We retrospectively reviewed our patients from 2012 to 2019 who had received either laparoscopic jejunostomy (LJ, n = 29) or open ones (OJ, n = 94) in Chang Gung Memorial Hospital, Linkou. Peri-operative data and postoperative outcomes were analyzed. Results In the current study, we employed 3-0 Vicryl, instead of V-loc barbed sutures, for laparoscopic jejunostomy. The mean operative duration of LJ group was about 30 min longer than the OJ group (159 ± 57.2 mins vs 128 ± 34.6 mins; P = 0.001). There were no intraoperative complications reported in both groups. The patients in the LJ group suffered significantly less postoperative pain than in the OJ group (mean NRS 2.03 ± 0.9 vs. 2.79 ± 1.2; P = 0.002). The majority of patients in both groups received early enteral nutrition (< 48 h) after the operation (86.2% vs. 74.5%; P = 0.143). Conclusions Our study demonstrated that purely laparoscopic feeding jejunostomy is a safe and feasible procedure with less postoperative pain and excellent postoperative outcome. It also provides surgeons opportunities to enhance intracorporeal suture techniques.
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Affiliation(s)
- Hsin-I Tsai
- Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou Medical Center, Guishan, Taoyuan, Taiwan, Republic of China.,College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China
| | - Ta-Chun Chou
- Department of Surgery, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China
| | - Ming-Chin Yu
- College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China.,Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, No.5, Fuxing St., Guishan Dist., Taoyuan, 33305, Taiwan, Republic of China.,Department of Surgery, New Taipei Municipal Tu-Cheng Hospital (Built and Operated By Chang Gung Medical Foundation), Tu-Cheng, New Taipei City, Taiwan, Republic of China
| | - Chun-Nan Yeh
- College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China.,Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, No.5, Fuxing St., Guishan Dist., Taoyuan, 33305, Taiwan, Republic of China
| | - Meng-Ting Peng
- Department of Hematology-Oncology, Chang Gung Memorial Hospital, Linkou Medical Center, Guishan, Taoyuan, Taiwan, Republic of China
| | - Chia-Hsun Hsieh
- College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China.,Department of Hematology-Oncology, Chang Gung Memorial Hospital, Linkou Medical Center, Guishan, Taoyuan, Taiwan, Republic of China.,Division of Hematology and Oncology, Department of Internal Medicine, New Taipei Municipal Tu-Cheng Hospital (Built and Operated by Chang Gung Medical Foundation), Tu-Cheng, New Taipei City, Taiwan, Republic of China
| | - Po-Jung Su
- College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China.,Department of Hematology-Oncology, Chang Gung Memorial Hospital, Linkou Medical Center, Guishan, Taoyuan, Taiwan, Republic of China.,Graduate Institute of Data Science, Taipei Medical University, Taipei, Taiwan, Republic of China
| | - Chiao-En Wu
- College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China.,Department of Hematology-Oncology, Chang Gung Memorial Hospital, Linkou Medical Center, Guishan, Taoyuan, Taiwan, Republic of China
| | - Yung-Chia Kuo
- College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China.,Department of Hematology-Oncology, Chang Gung Memorial Hospital, Linkou Medical Center, Guishan, Taoyuan, Taiwan, Republic of China
| | - Chien-Chih Chiu
- Department of Nursing, Chang Gung Memorial Hospital, Linkou Medical Center, Guishan, Taoyuan, Taiwan, Republic of China
| | - Chao-Wei Lee
- College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China. .,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan, Republic of China. .,Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, No.5, Fuxing St., Guishan Dist., Taoyuan, 33305, Taiwan, Republic of China.
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Volpe P, Domene CE, Santo MA, Cecconello I. Two port video-assisted gastrostomy and jejunostomy: technical simplification and clinical results. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2016; 28:57-60. [PMID: 25861072 PMCID: PMC4739252 DOI: 10.1590/s0102-67202015000100015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 12/09/2014] [Indexed: 01/14/2023]
Abstract
Background Patients presenting upper gastrointestinal obstruction, difficulty or inability in
swallowing, may need nutritional support which can be obtained through gastrostomy
and jejunostomy. Aim To describe the methods of gastrostomy and jejunostomy video-assisted, and to
compare surgical approaches for video-assisted laparoscopy and laparotomy in
patients with advanced cancer of the esophagus and stomach, to establish enteral
nutritional access. Methods Were used the video-assisted laparoscopic techniques for jejunostomy and
gastrostomy and the same procedures performed by laparotomies. Comparatively, were
analyzed the distribution of patients according to demographics, diagnosis and
type of procedure. Results There were 36 jejunostomies (18 by laparotomy and 17 laparoscopy) and 42
gastrostomies (21 on each side). In jejunostomy, relevant data were operating time
of 132 min vs. 106 min (p=0.021); reintroduction of diet: 3.3 days vs 2.1 days
(p=0.009); discharge: 5.8 days vs 4.3 days (p= 0.044). In gastrostomy, relevant
data were operative time of 122.6 min vs 86.2 min (p= 0.012 and hospital
discharge: 5.1 days vs 3.7 days (p=0.016). Conclusions The comparative analysis of laparotomy and video-assisted access to jejunostomies
and gastrostomies concluded that video-assisted approach is feasible method, safe,
fast, simple and easy, requires shorter operative time compared to laparotomy,
enables diet start soon in compared to laparotomy, and also enables lower length
of stay compared to laparotomy.
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Affiliation(s)
- Paula Volpe
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Carlos Eduardo Domene
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marco Aurélio Santo
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ivan Cecconello
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Young MT, Troung H, Gebhart A, Shih A, Nguyen NT. Outcomes of laparoscopic feeding jejunostomy tube placement in 299 patients. Surg Endosc 2015; 30:126-31. [PMID: 25801114 DOI: 10.1007/s00464-015-4171-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 03/06/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Jejunostomy catheters for jejunal feeding are an effective method to improve nutritional status in malnourish patients. However, this procedure is commonly being performed using an open approach, which can be associated with more postoperative pain and prolonged recovery. The objective of this study was to assess the outcomes of patients who underwent placement of feeding jejunostomy using a laparoscopic approach. METHODS A retrospective review was performed of patients who underwent laparoscopic jejunostomy tube placement between 1998 and 2014. Main outcome measures included indication for catheter placement, rate of conversion rate to open surgery, perioperative and late morbidity and in-hospital mortality. RESULTS Two hundred and ninety-nine consecutive patients underwent laparoscopic jejunostomy during the study period. The mean age was 64 years, and 81% of patients were male. The mean BMI was 26.2 kg/m(2). The most common indications for catheter placement were resectable esophageal cancer (78%), unresectable esophageal cancer (10%) and gastric cancer (6%). There were no conversions to open surgery. The 30-day complication rate was 4.0% and included catheter dislodgement (1%), intraperitoneal catheter displacement (0.7%), catheter blockage (1%) or breakage (0.3%), site infection requiring catheter removal (0.7%) and abdominal wall hematoma (0.3%). The late complication rate was 8.7% and included jejuno-cutaneous fistula (3.7%), jejunostomy tube dislodgement (3.3%), broken or clogged J-tube (1.3%) and small bowel obstruction (0.3%). The 30-day mortality was 0.3% for a patient with stage IV esophageal cancer who died in the postoperative period secondary to respiratory failure. CONCLUSION In this large consecutive series of feeding jejunostomy, the laparoscopic approach is feasible and safe and associated with a low rate of small bowel obstruction and no intraabdominal catheter-related infection.
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Affiliation(s)
- Monica T Young
- Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA.
| | - Hung Troung
- Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA
| | - Alana Gebhart
- Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA
| | - Anderson Shih
- Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA
| | - Ninh T Nguyen
- Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA.
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