Introduction A retrospective review of outcomes of laparoscopic insertion of feeding jejunostomy as a part of laparoscopic thoracoscopic cardio-oesophagectomy.
Methods From October 2010 to January 2012 (15 months) 18patients underwent laparoscopic thoracoscopic cardio-oesophagectomy. All 18 patients (12 male, 6 female) had laparoscopic insertion of Freka feeding jejunostomy are included in the study. The feeding jejunostomy was used for feeding from first postoperative day. The standard regime was water at 20 mls/h on day 1 followed by feed (jevity/osmolyte) at 30 mls/h on day 2. The rate of feed was increased at daily increments of 10 mls/h/day to achieve target rate to meet patient's nutritional requirements. Patients were discharged with feeding jejunostomy in situ, removed at follow-up if nutritionally stable.
Results The average procedure time was 20 min. Median duration of feeding jejunostomy in situ was 3 weeks (range 8 days–6 weeks). Tube related complications, n=3 patients (tube fallout-1, leak-2). Only one of these three patients needed additional parenteral nutrition. There were no procedure or feed related complications. The overall length of stay was not affected by this procedure. The availability of enteral route was useful in n=2 patients (chest infection-1, gastric stasis-1) for nutrition longer than the anticipated period.
Conclusion Laparoscopic insertion of feeding jejunostomy is safe, aids early establishment of enteral route for nutrition in patients undergoing cardio-oesophagectomy and useful in providing prolonged nutritional support in patients who develop complications were oral route is not possible.
Competing interests None declared.
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