155 Utility and Outcomes of Routine Jejunostomy Placement Following Uncomplicated Oesophagectomy

Résumé fourni par la source

Abstract Aim Feeding jejunostomy (FJ) is widely used as a nutritional adjunct in oesophagectomy. Nevertheless, it is associated with additional morbidity. While some patients, after major complications, require post-operative prolonged feeding adjuncts, evidence on the value of routine feeding jejunostomy is unclear and there is currently no consensus of practice. This study aimed to assess the utility and outcomes of feeding jejunostomy in patients with uncomplicated recovery after oesophagectomy. Method Outcomes for 100 consecutive patients who underwent oesophagectomy from September 2020 to November 2023 with uncomplicated recovery (Clavien-Dindo ≤2), who had FJ placement at time of surgery, were included from a prospectively maintained database. Necessity of FJ usage (as recommended by specialist dietician) and complications were recorded. Demographic, disease, operative and clinical outcomes were analysed. Differences between patients requiring post-discharge FJ use, and those who did not, were assessed. Results Complete data for a total of 97 patients were included. Overall, 9/97 (9.3%) patients required ongoing FJ usage on discharge. No significant differences in demographics between the two groups were observed. Postoperative complications were seen in 42/97 (43.3%) patients, most commonly respiratory complications. FJ-related complications were recorded in 18/97 (18.5%) patients, most commonly jejunostomy tube displacement. Conclusions The low rate of post-operative FJ usage and relatively high rate of associated complications suggests that a selective feeding jejunostomy placement strategy may have positive implications for patients, over a routine placement strategy. No significant predictive factors for requiring post-operative FJ use could be identified, work to define optimal post-operative feeding adjunct strategies is needed.

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