Laparoscopic feeding jejunostomy using T-tube-technique and analysis of outcomes

Authors

  • Raj Nihedan Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India https://orcid.org/0000-0002-0900-1179
  • Villalan Ramasamy Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India
  • Padmanabhan Subbareddiar Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India
  • Karthikeyan Srinivasan Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India
  • Balamurali Sankarasubbu Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20223590

Keywords:

Enteral feeding, Feeding jejunostomy, Laparoscopic, T-tube

Abstract

Background: Enteral nutrition is of paramount importance in management of upper gastrointestinal tract malignancies. Although various access routes for enteral nutrition are available, feeding jejunostomy tube is preferred to other methods. Since minimally invasive techniques have many advantages, we decided to perform it during staging laparoscopy.

Methods: The medical records of all patients who underwent laparoscopic feeding jejunostomy between October 2019 and September 2021, in the department of surgical gastroenterology, Madurai medical college were retrospectively reviewed. Patient demographics, ECOG performance status, types of malignancy, indications for feeding jejunostomy, operative time, time to start feeds, length of hospital stay and complications were analysed.

Results: 75 patients underwent laparoscopic feeding jejunostomies (51 men and 24 women), with a mean age of 51.6±11.7 years, using this method. ECOG performance status was between 0-2. Mean operating time was 83±8.8 minutes. Mean length of hospital stay was 3.5 days. There was no conversion, however one patient required reoperation for peritubal leak.

Conclusions: Feeding jejunostomy can be accomplished by a total laparoscopic technique using intracorporeal suturing. The technique we propose is relatively simple, reproducible, cost effective and can be widely adopted.

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Author Biographies

Raj Nihedan, Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India

Senior Resident, Department of Surgical Gastroenterology

Villalan Ramasamy, Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India

Assistant Professor, Department of Surgical Gastroenterology

Padmanabhan Subbareddiar, Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India

Professor & Head, Department of Surgical Gastroenterology

Karthikeyan Srinivasan, Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India

Associate Professor, Department of Surgical Gastroenterology

Balamurali Sankarasubbu, Department of Surgical Gastroenterology, Madurai Medical College, Madurai, Tamil Nadu, India

Senior Resident, Department of Surgical Gastroenterology

References

Gianotti L, Braga M, Vignali A. Effect of route of delivery and formulation of postoperative nutritional support in patients undergoing major operations for malignant neoplasms. Arch Surg. 1997;132:1222-30.

Moore FA, Feliciano DV, Andrassy RJ. Early enteral feeding compared with parenteral reduces postoperative septic complications: the results of a meta-analysis. Ann Surg. 1992;216:172-83

Heath EI, Kaufman HS, Talamini MA, Wu TT, Wheeler J, Heitmiller RF, et al. The role of laparoscopy in preoperative staging of esophageal cancer. Surg Endosc. 2000;14:495-9.

D’Ugo DM, Persiani R, Caracciolo F, Ronconi P, Coco C, Picciocchi A. Selection of locally advanced gastric carcinoma by preoperative staging laparoscopy. Surg Endosc. 1997;11:115962.

O’Regan PJ, Scarrow GD (1990) Laparoscopic Jejunostomy. Endoscopy. 1990;22:39-40

Sarr MG. Appropriate use, complications and advantages demonstrated in in 500 consecutive needle catheter jejunostomies. Br J Surg. 1999;86:557-61.

Duh QY, Way LW. Laparoscopic Jejunostomy using T-fasteners as retractors and anchors. Arch Surg. 1993;128:105-8.

Takita H, Vincent RG, Caicedo V, Gutierrez AC. Squamous cell carcinoma of the esophagus: a study of 153 cases. J Surg Oncol. 1977;9(6):547-54.

Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5(6):649-56.

Kaminski MV Jr. Enteral hyperalimentation. Surg Gynecol Obstet. 1976;143(1):12-6.

Koruda MJ, Guenter P, Rombeau JL. Enteral nutrition in the critically ill. Crit Care Clin. 1987;3(1):133-53.

Gauderer MWL, Ponsky JL, Izant RJ. Gastrostomy without laparotomy: A percutaneous endoscopic technique. J Pediatric Surg. 1980;15:872-5.

Gray RR, Ho CS, Yee A, Montanera W, Jones DP. Direct percutaneous jejunostomy. Am J Roentgenol. 1987;149(5):931-2.

Shike M, Latkany L, Gerdes H, Bloch AS. Direct percutaneous endoscopic jejunostomies for enteral feeding. Nutr Clin Pract. 1997;12(1):S38-42.

Gerndt SJ, Orringer MB. Tube jejunostomy as an adjunct to esophagectomy. Surgery. 1994;115(2):164-9.

Witzel O. On the technique of creating a gastric fistula. Centralbl Chir. 1891;18:601-4.

Sparrow P, David E, Pugash R. Direct percutaneous jejunostomy- an underutilized interventional technique? Cardiovasc Intervent Radiol. 2008;31(2):336-41.

van Overhagen H, Ludviksson MA, Laméris JS, Zwamborn AW, Tilanus HW, Dees J, et al. US and fluoroscopic-guided percutaneous jejunostomy: experience in 49 patients. J Vasc Intervent Radiol. 2000;11(1):101-6.

Glaser F, Sannwald GA, Buhr HJ. General stress response to conventional and laparoscopic cholecystectomy. Ann Surg. 1995;221:372-80

Pedersen AG, Petersen OB, Wara P. Randomized clinical trial of laparoscopic versus open appendicectomy. Br J Surg. 2001;88:200-5.

Han-Geurts IJM, Lim A, Stijnen T, Bonjer HJ. Laparoscopic feeding jejunostomy- a systematic review. Surg Endosc. 2005;19:951-7.

Morris JB, Mullen JL, Yu JC, Rosato EF. Laparoscopic-guided jejunostomy. Surgery. 1992;112(1):96-9.

Sangster W, Swanstrom L. Laparoscopic-guided feeding jejunostomy. Surg Endosc. 1993;7(4):308-10.

Tapia JJ, Garcı´a CG, Ramı´rez CC. Yeyunostomı´a laparosco´pica. Cir Gen. 1997;19:155.

Siow SL, Mahendran HA, Wong CM, Milaksh NK, Nyunt M. Laparoscopic T-tube feeding jejunostomy as an adjunct to staging laparoscopy for upper gastrointestinal malignancies: the technique and review of outcomes. BMC Surg. 2017;17(1):25.

Ye P, Zeng L, Sun F, An Z, Li Z, Hu J. A new modified technique of laparoscopic needle catheter jejunostomy: a 2-year follow-up study. Ther Clin Risk Manag. 2016;12:103-8.

Bhati G, Kalayarasan R, Pottakkat B. Laparoscopic Feeding Jejunostomy: a simple technique using Kehr’s T-Tube. 2017. Available from: http://doi.org/10.1089/vor.2016.0347. Accessed on 1 December 2021.

Allen JW, Spain DA. Open and laparoscopic surgical techniques for obtaining enteral access. Tech Gastrointest Endosc. 2001;3(1):50-4.

Allen JW, Ali A, Wo J, Bumpous JM, Cacchione RN. Totally laparoscopic feeding jejunostomy. Surg Endosc. 2002;16:1802-5.

Mistry RC, Mehta SS, Karimundackal G, Pramesh CS. Novel cost-effective method of laparoscopic feeding-jejunostomy. J Minim Access Surg. 2009;5:43-6.

Ben-David K, Kim T, Caban AM, Rossidis G, Rodriguez SS, Hochwald SN. Pretherapy laparoscopic feeding jejunostomy is safe and effective in patients undergoing minimally invasive esophagectomy for cancer. J Gastrointest Surg. 2013;17:1352-8.

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Published

2022-12-30

How to Cite

Nihedan, R., Ramasamy, V., Subbareddiar, P., Srinivasan, K., & Sankarasubbu, B. (2022). Laparoscopic feeding jejunostomy using T-tube-technique and analysis of outcomes. International Surgery Journal, 10(1), 46–52. https://doi.org/10.18203/2349-2902.isj20223590

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Original Research Articles