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Feeding Jejunostomy Tube Placed during Esophagectomy: Is There an Effect on Postoperative Outcomes?
Al-Temimi, Mohammed H; Dyurgerova, Anya M; Kidon, Michael; Johna, Samir.
Afiliación
  • Al-Temimi MH; Department of Surgery, Fontana Medical Center, CA.
  • Dyurgerova AM; Department of Surgery, Baylor University Medical Center, Dallas, TX.
  • Kidon M; Western University of Osteopathic Medicine, Pomona, CA.
  • Johna S; Touro University of Osteopathic Medicine, Henderson, NV.
Perm J ; 232019.
Article en En | MEDLINE | ID: mdl-31496496
ABSTRACT

BACKGROUND:

Feeding jejunostomy (FJ) tubes are routinely placed during esophagectomy. However, their effect on immediate postoperative outcomes in this patient population is not clear.

OBJECTIVES:

To evaluate the effect of FJ tube placement during esophagectomy on postoperative morbidity and mortality.

METHODS:

The National Surgical Quality Improvement Program database was used to evaluate the effect of FJ tube placement during esophagectomy on 30-day postoperative morbidity and mortality rates. A propensity score-matched cohort was used to compare postoperative outcomes of patients with and without FJ tubes.

RESULTS:

An FJ tube was placed in 45% of 2059 patients undergoing esophagectomy. The anastomotic leak rate was 13.5%. Patients with FJ tubes were more likely to have preoperative radiation therapy (59.6% vs 54.9%, p = 0.041), transhiatal esophagectomy (21.5% vs 19.2%, p = 0.012), a malignant diagnosis (93.2% vs 90.4%), and longer operative time (393 min vs 348 min, p < 0.001). In a case-matched cohort, mortality (2% vs 2.4%, p = 0.618) and severe morbidity (38.2% vs 34.6%, p = 0.128) were comparable between patients with and without FJ tubes. FJ tube placement was associated with higher overall morbidity (46% vs 38.6%, p = 0.002), superficial wound infection (6.3% vs 2.9%, p = 0.001), and return to the operating room (16.7% vs 12.5%, p = 0.016). In a subgroup of patients with anastomotic leak, FJ was associated with shorter hospital stay (20.1 days vs 24.3 days, p = 0.046).

CONCLUSION:

These mixed findings support selective rather than routine FJ tube placement during esophagectomy.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 6_ODS3_enfermedades_notrasmisibles Problema de salud: 6_digestive_diseases Asunto principal: Yeyunostomía / Esofagectomía / Nutrición Enteral Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Perm J Año: 2019 Tipo del documento: Article País de afiliación: Canadá

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 6_ODS3_enfermedades_notrasmisibles Problema de salud: 6_digestive_diseases Asunto principal: Yeyunostomía / Esofagectomía / Nutrición Enteral Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Perm J Año: 2019 Tipo del documento: Article País de afiliación: Canadá
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