In which cases surgical gastrostomy and jejunostomy techniques are inevitable?
OBJECTIVE
This study investigated the surgical gastrostomy and jejunostomy procedures in cancer patients who needed nutritional support and endoscopy was unattainable.


METHODS
Operation time and procedure, anesthesia and tube types, procedure-specific and surgical complications, and tube replacement at the follow up period were retrospectively analyzed.


RESULTS
109 patients (44 female, 65 male, mean age 50.9 years, range 14-87) were subjected to surgical gastrostomy/ jejunostomy. Ninety-three (85.4%) patients had head-neck and gastrointestinal cancers. In 94 (86.2%) patients endoscopy was impossible due to obstruction of the esophagus and stomach. Gastrostomy/jejunostomy was combined with other surgical procedures in 12 (11 %) patients. Procedure- related complications occurred in 22 (20.7%) patients. Early 30-day mortality occurred in 12 (11 %) cases. The median follow up period was 3.6 months (range 0-18).


CONCLUSIONS
Obstructing cancer, obesity or previous laparotomy make the use of endoscopic techniques impossible. For these patients, surgical gastrostomy/jejunostomy is safe with acceptable complication rates and improves the treatment outcomes with nutritional support.
Department of General Surgery, Ankara Diskapi Training and Research Hospital, Ankara, Turkey.
K
K
Bora Yilmaz
L
L
Dogan
M
M
Akinci
C
C
Atalay
N
N
Karaman
O
O
Canoler
C
C
Ozaslan
H
H
Kulacoglu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000601:surgery*; D005774:Gastrostomy; D006258:Head and Neck Neoplasms / Q000150:complications / Q000601:surgery*; D006801:Humans; D007415:Intestinal Obstruction; D007582:Jejunostomy; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult