Successful enteral nutrition in the treatment of esophagojejunal fistula after total gastrectomy in gastric cancer patients.
BACKGROUND
Esophagojejunal fistula is a serious complication after total gastrectomy in gastric cancer patients. This study describes the successful conservative management in 3 gastric cancer patients with esophagojejunal fistula after total gastrectomy using total enteral nutrition.


METHODS
Between January 2004 to December 2008, 588 consecutive patients with a proven diagnosis of gastric cancer were taken to the operation room to try a curative treatment. Of these, 173 underwent total gastrectomy, 9 of them had esophagojejunal fistula (5.2%). In three selected patients a trans-anastomotic naso-enteral feeding tube was placed under fluoroscopic vision when the fistula was clinically detected and a complete polymeric enteral formula was used.


RESULTS
The complete closing of the esophagojejunal fistula was obtained in day 8, 14 and 25 respectively.


CONCLUSIONS
In some selected cases it is possible to make a successful enteral nutrition using a feeding tube distal to the leak area inserted with the help of fluoroscopic vision. The specialized management of a gastric surgery unit and nutritional therapy unit are highlighted.
Portanova
Michel
M
Gastric Cancer Service, Department of General Surgery, Rebagliati National Hospital, Lima, Perú. michelportanova@yahoo.com
D004750:Enteral Nutrition; D004937:Esophageal Fistula / Q000209:etiology / Q000628:therapy*; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D007579:Jejunal Diseases / Q000209:etiology / Q000628:therapy*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome