title: Single-incision laparoscopic-assisted jejunostomy tube placement.
abstract: BACKGROUND
  Feeding jejunostomy is an alternative enteral nutritional supplementation method for patients with functional gastrointestinal tracts. In this study, we introduced the novel, safe technique of single-incision laparoscopic-assisted jejunostomy (SIL-AJ) tube placement.
  
  
  METHODS
  We conducted a prospective record search and a retrospective review of all patients who received surgical jejunostomy tube placement in Chang Gung Memorial Hospital, Linkou, Taiwan, from October 2011 to December 2012. SIL-AJ, multiple-incision laparoscopic jejunostomy (MIL-J), and open jejunostomy (O-J) were performed concurrently. We compared the demographic data, operative time, postoperative pain control, and postoperative complications among these groups.
  
  
  RESULTS
  Forty patients who received surgical jejunostomy in this period were enrolled in the study. There were 14 patients with SIL-AJ, 10 with MIL-J, and 16 with O-J. There were no differences in age, sex, American Society of Anesthesiologists status, body mass index, or malignancy distribution among the SIL-AJ, MIL-J, and O-J groups. The total operative times for the SIL-AJ, MIL-J, and O-J procedures were 53.3±11.5, 117.3±45.8, and 52.9±16.1 minutes, respectively; SIL-AJ and O-J had similar operative times, which were significantly shorter than the operative times in the MIL-J group (P<.001). The proportions of patients who began feeding within 24 hours in the SIL-AJ, MIL-J, and O-J groups were 100%, 70%, and 37%, respectively; the SIL-AJ group had a higher feeding rate at 24 hours than the two other groups (P=.001). The SIL-AJ and MIL-J groups had fewer postoperative complications than the O-J group (P=.011).
  
  
  CONCLUSIONS
  SIL-AJ is a feasible and safe procedure that can be performed in patients who require alternative enteral feeding. Reduced postoperative pain, acceptable incisions, and quick feeding were observed in patients with SIL-AJ. Transumbilical SIL-AJ uses cost-effective appliances, and it is a relatively simple technique to learn and in which togain proficiency.
authors: 1 Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University , Taoyuan, Taiwan .
authors: Yu-Yin
authors: YY
authors: Liu
authors: Chien-Hung
authors: CH
authors: Liao
authors: Chih-Chi
authors: CC
authors: Chen
authors: Chun-Yi
authors: CY
authors: Tsai
authors: Keng-Hao
authors: KH
authors: Liu
authors: Shang-Yu
authors: SY
authors: Wang
authors: Chih-Yuan
authors: CY
authors: Fu
authors: Chun-Nan
authors: CN
authors: Yeh
authors: Ta-Sen
authors: TS
authors: Yeh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D007582:Jejunostomy / Q000295:instrumentation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain; D011183:Postoperative Complications; D011446:Prospective Studies; D012189:Retrospective Studies; D013624:Taiwan