title: Interim results of nutritional support through a button-type jejunostomy after total gastrectomy.
abstract: Nutritional deficiency is an inevitable consequence after total gastrectomy. We have recently developed a simple technique for nutritional support after total gastrectomy, in which the button jejunostomy is conducted on the afferent limb for long-term jejunal feeding. The purpose of this study was to evaluate the safety and efficacy of the low-profile button jejunostomy (LBJ) in patients with gastric malignancy. The records of 55 consecutive patients who were treated by total gastrectomy along with LBJ-making for gastric malignancy were prospectively reviewed and analyzed. Outcome parameters such as body weight, per cent ideal body weight (IBW), and nutritional parameters were regularly measured preoperatively and postoperatively. There were no complications related to LBJ. Among the patients, 53 who had survived at least 6 months after surgery were evaluated. The median caloric supplement by enteral feeding at home was 800 kcal per day. The median weight loss was 10.7 per cent of initial body weight. More than half of the patients achieved IBW and 40 patients (75%) were classified as low or no risk of malnutrition. This technique is easy to perform with minimal discomfort, and we believe that LBJ is useful for supporting dietary intake and for preventing malnutrition after total gastrectomy.
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, Nishi-shinbashi, 3-25-8, Minato-ku, Tokyo 105-8461, Japan. shinohara@jikei.ac.jp
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Shinohara
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Fujita
authors.forename: Yukata
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Sano
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kashiwagi
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003677:Deficiency Diseases / Q000209:etiology / Q000517:prevention & control*; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D008223:Lymphoma / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome