Complications of Jejunostomy Feeding Tubes

“To help mitigate the perioperative risks of poor nutrition status, nutritional interventions via either parenteral or enteral techniques are available. For these reasons, especially in the
setting of foregut reconstruction and planned return to oncology therapy, our bias has been the use of postoperative jejunal feeding tube access in our surgical oncology population in
high-risk and nutritionally depleted patients. Jejunostomy feeding tubes are not without complication, however, with high reported rates of tube dysfunction. Jejunostomy tubes
can be easily dislodged, have imperfect seals at wound exit sites leading to leakage, and can be somewhat cumbersome for patients and caregivers to maintain. Some authors have
begun to advocate for the selective placement of jejunostomy tubes following gastric and esophageal resections.”

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A randomised trial of post-discharge enteral feeding following surgical resection of an upper gastrointestinal malignancy

Froghi F, et al. A randomised trial of post-discharge enteral feeding following surgical resection of an upper gastrointestinal malignancy. Clin Nutr. 2017 Dec;36(6):1516-1519.

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RESULTS: 44 patients (M:F, 29:15) were randomised, 23 received jejunal supplements. There were no differences between the groups. Percentage of calculated energy requirement received was greater in the supplemented group at weeks 3 and 6 (p < 0.0001). Oral energy intake was not different between the groups at any time period. After hospital discharge, there were no differences in MFI-20, EQ5D and QLQ-OES18 scores at any time point. From hospital discharge fatigue improved and plateaued at 6 weeks (p < 0.05 for both groups), independence at 12 weeks (p < 0.05 for both groups). No improvement was seen in quality of life until 24 weeks in the active group alone (p < 0.02) and not at all in the control group.

CONCLUSIONS: Addition of jejunal feeding is effective in providing patients with an adequate energy intake. Increased energy intake however, produced no obvious improvement in measures of fatigue, quality of life or health economics.