title: Outcomes of laparoscopic feeding jejunostomy tube placement in 299 patients.
abstract: BACKGROUND
  Jejunostomy catheters for jejunal feeding are an effective method to improve nutritional status in malnourish patients. However, this procedure is commonly being performed using an open approach, which can be associated with more postoperative pain and prolonged recovery. The objective of this study was to assess the outcomes of patients who underwent placement of feeding jejunostomy using a laparoscopic approach.
  
  
  METHODS
  A retrospective review was performed of patients who underwent laparoscopic jejunostomy tube placement between 1998 and 2014. Main outcome measures included indication for catheter placement, rate of conversion rate to open surgery, perioperative and late morbidity and in-hospital mortality.
  
  
  RESULTS
  Two hundred and ninety-nine consecutive patients underwent laparoscopic jejunostomy during the study period. The mean age was 64 years, and 81% of patients were male. The mean BMI was 26.2 kg/m(2). The most common indications for catheter placement were resectable esophageal cancer (78%), unresectable esophageal cancer (10%) and gastric cancer (6%). There were no conversions to open surgery. The 30-day complication rate was 4.0% and included catheter dislodgement (1%), intraperitoneal catheter displacement (0.7%), catheter blockage (1%) or breakage (0.3%), site infection requiring catheter removal (0.7%) and abdominal wall hematoma (0.3%). The late complication rate was 8.7% and included jejuno-cutaneous fistula (3.7%), jejunostomy tube dislodgement (3.3%), broken or clogged J-tube (1.3%) and small bowel obstruction (0.3%). The 30-day mortality was 0.3% for a patient with stage IV esophageal cancer who died in the postoperative period secondary to respiratory failure.
  
  
  CONCLUSIONS
  In this large consecutive series of feeding jejunostomy, the laparoscopic approach is feasible and safe and associated with a low rate of small bowel obstruction and no intraabdominal catheter-related infection.
authors: Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA. mtyoung@uci.edu.
authors: Monica T
authors: MT
authors: Young
authors: Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA.
authors: Hung
authors: H
authors: Troung
authors: Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA.
authors: Alana
authors: A
authors: Gebhart
authors: Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA.
authors: Anderson
authors: A
authors: Shih
authors: Department of Surgery, University of California, Irvine School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA, 92868, USA. ninhn@uci.edu.
authors: Ninh T
authors: NT
authors: Nguyen
mesh_terms: D004750:Enteral Nutrition / Q000295:instrumentation / Q000379:methods*; D004938:Esophageal Neoplasms / Q000150:complications; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects; D007582:Jejunostomy / Q000009:adverse effects; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications
keywords: Esophageal cancer; Feeding jejunostomy; Laparoscopic jejunostomy; Tube jejunostomy