A prospective cohort study of feeding needle catheter jejunostomy in an upper gastrointestinal surgical unit.
OBJECTIVE
Feeding jejunostomy is recommended to facilitate early enteral nutrition after major upper gastrointestinal surgery. We aimed to determine the benefits and risks associated with routine practice of feeding needle catheter jejunostomy (NCJ) in high-risk upper gastrointestinal surgery.


METHODS
This is a prospective consecutive cohort study of 84 patients underwent feeding NCJ over a 3 years period in an Upper Gastrointestinal Surgical Unit.


RESULTS
Feeding NCJ was placed after two-stage oesophago-gastrectomy in 24 patients (28.6%), after gastrectomy in 29 patients (34.5%), after liver resections in 7 patients (8.3%), pancreatic resection in 6 patients (7.1%), bile duct reconstruction in 8 patients (9.5%) and other operations in 10 patients (12%). The mean (SE) estimated nutritional requirement per 24 h was 1791 (31)kcal. Eighty-two patients (98%) started enteral feed on day 1 after surgery. Fifty-seven patients (68%) achieved the target nutritional requirements in 3 days. Four patients were discharged home on jejunal feed whilst only two patients required parenteral nutrition support. The rest tolerated full oral diet. There was no procedure related mortality. The morbidity related to feeding tube and feeding were 12.9% and 20%, respectively.


CONCLUSIONS
Routine practice of feeding NCJ is safe. Their benefits outweigh the risks in a specialist centre.
Department of General Surgery, York Hospital, Wigginton Road, York YO31 8HE, UK.
Kin-Fah
KF
Chin
Sara
S
Townsend
Wingzou
W
Wong
Glenn V
GV
Miller
D002404:Catheterization; D015331:Cohort Studies; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000601:surgery* / Q000628:therapy*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D007582:Jejunostomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D011182:Postoperative Care; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012449:Safety; D016896:Treatment Outcome