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Difficult Decisions in Thoracic Surgery pp 242–249Cite as

Jejunostomy after Esophagectomy

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Abstract

Esophageal resection is indicated most often for treatment of localized esophageal cancer and Barrett’s esophagus with high grade dysplasia. Despite the improved techniques utilized for resection, Karl and colleagues report esophagectomy continues to be associated with a 30-day mortality of 2.1% and a 3-year survival of 29.6%. Overall, 29% of patients experience complications such as anastomotic leaks (3.5%) and pulmonary complications (19%). Approximately 58% of patients with esophageal cancer present with significant weight loss. These patients often have nutritional deficiencies due to the obstructive nature of the tumor and the catabolic effects of the malignancy. Poor preoperative nutritional status may increase the risk of postoperative complications and therefore nutritional support is a treatment modality that may directly impact outcomes.

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References

  1. Bueno JT, Schattner MA, Barrera R, et al. Endoscopic placement of direct percutaneous jejunostomy tubes in patients with complications after esophagectomy. Gastrointest Endosc 2003;57:536–540.

    Article  PubMed  Google Scholar 

  2. DeCamp MM Jr, Swanson SJ, Jaklitsch MT. Esophagectomy after induction chemoradiation. Chest 1999;116(suppl 6):466S–469S.

    Article  PubMed  Google Scholar 

  3. Karl RC, Schreiber R, Boulware D, et al. Factors affecting morbidity, mortality, and survival in patients undergoing Ivor Lewis esophagogastrectomy. Ann Surg 2000;231:635–643.

    Article  PubMed  CAS  Google Scholar 

  4. Gurski RR, Schirmer CC, Rosa AR, et al. Nutritional assessment in patients with squamous cell carcinoma of the esophagus. Hepatogastroenterology 2003;50:1943–1947.

    PubMed  Google Scholar 

  5. Page RD, Oo AY, Russell GN, et al. Intravenous hydration versus naso-jejunal enteral feeding after esophagectomy: a randomised study. Eur J Cardiothorac Surg 2002;22:666–672.

    Article  PubMed  Google Scholar 

  6. Baigrie RJ, Devitt PG, Watkin DS. Enteral versus parenteral nutrition after oesophagogastric surgery: a prospective randomized comparison. Aust N Z J Surg 1996;66:668–670.

    PubMed  CAS  Google Scholar 

  7. Gerndt SJ, Orringer MB. Tube jejunostomy as an adjunct to esophagectomy. Surgery 1994;115:164–169.

    PubMed  CAS  Google Scholar 

  8. Wakefield SE, Mansell NJ, Baigrie RJ, et al. Use of a feeding jejunostomy after oesophagogastric surgery. Br J Surg 1995;82:811–813.

    Article  PubMed  CAS  Google Scholar 

  9. Lacey JM, Wilmore DW. Is glutamine a conditionally essential amino acid? Nutr Rev 1990;48:297–309.

    Article  PubMed  CAS  Google Scholar 

  10. Takagi K, Yamamori H, Toyoda Y, et al. Modulating effects of the feeding route on stress response and endotoxin translocation in severely stressed patients receiving thoracic esophagectomy. Nutrition 2000;16:355–360.

    Article  PubMed  CAS  Google Scholar 

  11. Ephgrave KS, Brasel KJ, Cullen JJ, et al. Gastric mucosal protection from enteral nutrients: role of motility. J Am Coll Surg 1998;186:434–440.

    Article  PubMed  CAS  Google Scholar 

  12. Dudrick SJ, Wilmore DW, Vars HM, et al. Longterm total parenteral nutrition with growth, development, and positive nitrogen balance. Surgery 1968;64:134–142.

    PubMed  CAS  Google Scholar 

  13. Scolapio JS. A review of the trends in the use of enteral and parenteral nutrition support. J Clin Gastroenterol 2004;38:403–407.

    PubMed  Google Scholar 

  14. Finck C. Enteral versus parenteral nutrition in the critically ill. Nutrition 2000;16:393–394.

    Article  PubMed  CAS  Google Scholar 

  15. Trahan K, Gore DC. Nutritional support. Chest Surg Clin N Am 2002;12:227–249, v.

    Article  PubMed  Google Scholar 

  16. Heslin MJ, Latkany L, Leung D, et al. A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy. Ann Surg 1997;226:567–580.

    Article  PubMed  CAS  Google Scholar 

  17. Lewis SJ, Egger M, Sylvester PA, et al. Early enteral feeding versus “nil by mouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ 2001;323:773–776.

    Article  PubMed  CAS  Google Scholar 

  18. Carr CS, Ling KD, Boulos P, et al. Randomised trial of safety and efficacy of immediate postoperative enteral feeding in patients undergoing gastrointestinal resection. Br Med J 1996;312:869–871.

    CAS  Google Scholar 

  19. Bozzetti F, Gavazzi C, Miceli R, et al. Perioperative total parenteral nutrition in malnourished, gastrointestinal cancer patients: a randomized, clinical trial. JPEN J Parenter Enteral Nutr 2000;24:7–14.

    Article  PubMed  CAS  Google Scholar 

  20. Perioperative total parenteral nutrition in surgical patients. The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. N Engl J Med 1991;325:525–532.

    Google Scholar 

  21. Bozzetti F, Braga M, Gianotti L, et al. Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomised multicentre trial. Lancet 2001;358:1487–1492.

    Article  PubMed  CAS  Google Scholar 

  22. Braunschweig CL, Levy P, Sheean PM, et al. Enteral compared with parenteral nutrition: a metaanalysis. Am J Clin Nutr 2001;74:534–542.

    PubMed  CAS  Google Scholar 

  23. Salvino RM, Dechicco RS, Seidner DL. Perioperative nutrition support: who and how. Cleve Clin J Med 2004;71:345–351.

    Article  PubMed  Google Scholar 

  24. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. JPEN J Parenter Enteral Nutr 2002;26(suppl 1):1SA–138SA.

    Google Scholar 

  25. Sand J, Luostarinen M, Matikainen M. Enteral or parenteral feeding after total gastrectomy: prospective randomised pilot study. Eur J Surg 1997;163:761–766.

    PubMed  CAS  Google Scholar 

  26. Gabor S, Renner H, Matzi V, et al. Early enteral feeding compared with parenteral nutrition after oesophageal or oesophagogastric resection and reconstruction. Br J Nutr 2005;93:509–513.

    Article  PubMed  CAS  Google Scholar 

  27. Watters JM, Kirkpatrick SM, Norris SB, et al. Immediate postoperative enteral feeding results in impaired respiratory mechanics and decreased mobility. Ann Surg 1997;226:369–380.

    Article  PubMed  CAS  Google Scholar 

  28. Finley FJ, Lamy A, Clifton J, et al. Gastrointestinal function following esophagectomy for malignancy. Am J Surg 1995;169:471–475.

    Article  PubMed  CAS  Google Scholar 

  29. Smith RC, Hartemink RJ, Hollinshead JW, et al. Fine bore jejunostomy feeding following major abdominal surgery: a controlled randomized clinical trial. Br J Surg 1985;72:458–461.

    Article  PubMed  CAS  Google Scholar 

  30. Yagi M, Hashimoto T, Nezuka H, et al. Complications associated with enteral nutrition using catheter jejunostomy after esophagectomy. Surg Today 1999;29:214–218.

    Article  PubMed  CAS  Google Scholar 

  31. Zapas JL, Karakozis S, Kirkpatrick JR. Prophylactic jejunostomy: a reappraisal. Surgery 1998;124:715–720.

    Article  PubMed  CAS  Google Scholar 

  32. McCarter MD, Gomez ME, Daly JM. Early postoperative enteral feeding following major upper gastrointestinal surgery. J Gastrointest Surg 1997;1:278–285.

    Article  PubMed  CAS  Google Scholar 

  33. Brock MV, Venbrux AC, Heitmiller RF. Percutaneous replacement jejunostomy after esophagogastrectomy. J Gastrointest Surg 2000;4:407–410.

    Article  PubMed  CAS  Google Scholar 

  34. Adams MB, Seabrook GR, Quebbeman EA, et al. Jejunostomy. A rarely indicated procedure. Arch Surg 1986;121:236–238.

    PubMed  CAS  Google Scholar 

  35. Cogen R, Weinryb J, Pomerantz C, et al. Complications of jejunostomy tube feeding in nursing facility patients. Am J Gastroenterol 1991;86:1610–1613.

    PubMed  CAS  Google Scholar 

  36. Smith-Choban P, Max MH. Feeding jejunostomy: a small bowel stress test? Am J Surg 1988;155: 112–117.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of General and General Thoracic Surgery, The University of Texas Medical Branch, Galveston, TX, USA

    Lindsey A. Clemson MD

  2. Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA

    Christine Fisher MD & Terrell A. Singleton MD

  3. Department of Cardiothoracic and Ceneral Thoracic Surgery, The University of Texas Medical Branch, Galveston, TX, USA

    Joseph B. Zwischenberger MD

Authors
  1. Lindsey A. Clemson MD
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  2. Christine Fisher MD
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  3. Terrell A. Singleton MD
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  4. Joseph B. Zwischenberger MD
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Editor information

Editors and Affiliations

  1. Department of Surgery, The University of Chicago, Chicago, IL, USA

    Mark K. Ferguson MD (Professor and Head) (Professor and Head)

  2. Thoracic Surgery Service, The University of Chicago Hospitals, Chicago, IL, USA

    Mark K. Ferguson MD (Professor and Head) (Professor and Head)

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© 2007 Springer-Verlag London Limited

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Clemson, L.A., Fisher, C., Singleton, T.A., Zwischenberger, J.B. (2007). Jejunostomy after Esophagectomy. In: Ferguson, M.K. (eds) Difficult Decisions in Thoracic Surgery. Springer, London. https://doi.org/10.1007/978-1-84628-474-8_29

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  • DOI: https://doi.org/10.1007/978-1-84628-474-8_29

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-384-0

  • Online ISBN: 978-1-84628-474-8

  • eBook Packages: MedicineMedicine (R0)

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