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J Gastrointest Surg. 2016 May;20(5):970-5. doi: 10.1007/s11605-016-3094-2. Epub 2016 Feb 19.

Clinical Burden of Laparoscopic Feeding Jejunostomy Tubes.

Author information

1
Department of Surgery, Providence Portland Medical Center, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA.
2
Department of Surgery, Legacy Good Samaritan Hospital, 1040 NW 22nd Ave, Suite 520, Portland, OR, 97210, USA.
3
Department of Surgery, Providence Portland Medical Center, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA. cdunst@orclinic.com.
4
Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA. cdunst@orclinic.com.
5
Foundation for Surgical Innovation and Education, 4805 NE Glisan St., Suite 6N60, Portland, OR, 97213, USA. cdunst@orclinic.com.
6
Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA.
7
Foundation for Surgical Innovation and Education, 4805 NE Glisan St., Suite 6N60, Portland, OR, 97213, USA.
8
Institut Hospitalo Universitaire Strasbourg, 1, Place de l'Hôpital, 97000, Strasbourg, France.

Abstract

INTRODUCTION:

Feeding jejunostomies (J tubes) provide enteral nutrition when oral and gastric routes are not options. Despite their prevalence, there is a paucity of literature regarding their efficacy and clinical burden.

METHODS:

All laparoscopic J tubes placed over a 5-year period were retrospectively reviewed. Clinical burden was measured by number of clinical contact events (tube-related clinic visits, phone calls, ED visits) and morbidity (dislodgement, clogging, tube fracture, infection, other). Tube replacements were also recorded.

RESULTS:

One hundred fifty-one patients were included. Fifty-nine percent had associated malignancy, and 35 % were placed for nutritional prophylaxis. Mean time to J tube removal was 146 days. J tubes were expected to be temporary in >90 % but only 50 % had sufficient oral intake for removal. Tubes were removed prematurely due to patient intolerance in 8 %. Mortality was 0 %. Morbidity was 51 % and included clogging (12 %), tube fracture (16 %), dislodgement (25 %), infection (18 %) and "other" (leaking, erosion, etc.) in 17 %. The median number of adverse events per J tube was 2(0-8). Mean number of clinic phone calls was 2.5(0-22), ED visits 0.5(0-7), and clinic visits 1.4(0-13), with 82 % requiring more than one J tube-related clinic visit. Unplanned replacements occurred in 40 %.

CONCLUSION:

While necessary for some patients, J tubes are associated with high clinical burden.

KEYWORDS:

Burden; Enteral nutrition; Feeding tube; Jejunostomy; Laparoscopic feeding jejunostomy; Laparoscopy

PMID:
26895952
DOI:
10.1007/s11605-016-3094-2
[Indexed for MEDLINE]

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