Complications Associated with Enteral Nutrition Using Tube Jejunostomy after Esophageal Reconstruction
Department of Digestive Surgery, Beni-Messous Hospital, University of Algiers, Algiers, Algeria
- Corresponding Author:
- A. Boukerrouche
Department of Digestive Surgery
University of Algiers
Email: [email protected]
Received Date: December 12, 2014; Accepted Date: January 20, 2015; Published Date: January 30, 2015
Citation: Boukerrouche A (2015) Complications Associated with Enteral Nutrition Using Tube Jejunostomy after Esophageal Reconstruction. J Gastrointest Dig Syst 5:252. doi:10.4172/2161-069X.1000252
Copyright: ©2015 Boukerrouche A. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Esophageal reconstruction is a major surgery using a digestive graft. The nutritional support impacts directly outcomes of patients. The enteral route is the preferred one for instituting postoperative nutrition. Most complications was related to the methods of tube-jejunostomy. The purpose of this retrospective study to examine the complications associated with EN using a Witzel-type tube-feeding jejunostomy for postoperative nutritional support in esophageal reconstructive surgery.
Patients and Methods: Between 1999 and 2014, 105 patients underwent esophageal reconstruction by colon interposition and gastric tube. The mean age was 25.52 ± 13.86 years and the male/female ratio was 6.10. A Witzel-type tube-feeding jejunostomy was performed. The jejunum was attached to the peritoneum over a length of 5-8 cm. The number of calories administered was increased gradually. The complications associated with tube-jejunostomy and enteral nutrition were noted.
Results: The tube-feeding jejunostomy was could be placed in all patients. The postoperative nutrition by tube-jejunostomy was begun at day 1 in 41 patients (39 %) and day 7 in 64 patients after surgery. EN was well tolerated by all patients. The complication associated with the tube-jejunostomy was skin erosion at the entry of tube. One patient was re-operated for obstruction. The dislogement and blockage of tube were produced respectively in 1 and 2 patients. Abdominal pain and/or diarrhea was experienced by five patient. The complication rates related to the enteral nutrients and to placement of tube jejunostomy, were 4.7% and 2.8%, respectively.
Conclusion: The attachment of the jejunal wall to the peritoneum at the place of entry of the catheter/tube is useful to prevent leakage and twisting of the jejunum and to reduce the severity of the complications related to catheter/tube jejunostomy feeding.