evaluation of the relationship between the initiation times of feeding through Jejunostomy and procedure complications after upper gastrointestinal [hypopharynx-esophagus] malignancy

ABSTRACT

Jejunostomy is a common route for enteral nutrition in patient s with upper gastrointestinal [hypopharynx-esophagus] surgery. The aim of this study was to assess the relationship between the starting time of feeding through Jejunostomy with this resulting complications and suggesting a new guideline to reduce complications of the procedure. In a clinical trial study in Amir-Alam hospital patients with upper gastrointestinal malignancy underwent Jejunostomy in a 3 year- period. The patients divided in two groups and complication rates compared feeding through Jejunostomy group [A] 6 hours after the main surgery and group [B] 3 days after the main procedure. Ninety patients [41 male, mean age 55 yr of age ranging 20-90yr] with upper gastrointestinal malignancy were recruited. In each group twenty seven [30%] of the patients did not complain of any side effect during enteral nutrition .The complications of Jejunostomy procedure in group [A] 6 hours and in group [B] 3 days after the main surgery was seen in 12/37 [32%] and 13/53[24%] of the patients respectively. Significantly higher incidence of abdominal distention and fever was observed in group [A] patients who underwent enteral nutrition through Jejunostomy 6 hours after the main surgery, compared to group [B] [P=0.001] and [P=0.001], respectively. No significant differences in other complications were observed between the two groups. Feeding through Jejunostomy 3 days after the main surgical procedure shows lower adverse effect and because of its well toleration in upper gastrointestinal tract and hypopharyngeal cancer, this method is recommended for enteral nutrition in these patients