title: Two port video-assisted gastrostomy and jejunostomy: technical simplification and clinical results.
abstract: BACKGROUND
  Patients presenting upper gastrointestinal obstruction, difficulty or inability in swallowing, may need nutritional support which can be obtained through gastrostomy and jejunostomy.
  
  
  OBJECTIVE
  To describe the methods of gastrostomy and jejunostomy video-assisted, and to compare surgical approaches for video-assisted laparoscopy and laparotomy in patients with advanced cancer of the esophagus and stomach, to establish enteral nutritional access.
  
  
  METHODS
  Were used the video-assisted laparoscopic techniques for jejunostomy and gastrostomy and the same procedures performed by laparotomies. Comparatively, were analyzed the distribution of patients according to demographics, diagnosis and type of procedure.
  
  
  RESULTS
  There were 36 jejunostomies (18 by laparotomy and 17 laparoscopy) and 42 gastrostomies (21 on each side). In jejunostomy, relevant data were operating time of 132 min vs. 106 min (p = 0.021); reintroduction of diet: 3.3 days vs 2.1 days (p = 0.009); discharge: 5.8 days vs 4.3 days (p = 0.044). In gastrostomy, relevant data were operative time of 122.6 min vs 86.2 min (p = 0.012 and hospital discharge: 5.1 days vs 3.7 days (p = 0.016).
  
  
  CONCLUSIONS
  The comparative analysis of laparotomy and video-assisted access to jejunostomies and gastrostomies concluded that video-assisted approach is feasible method, safe, fast, simple and easy, requires shorter operative time compared to laparotomy, enables diet start soon in compared to laparotomy, and also enables lower length of stay compared to laparotomy.
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: Paula
authors: P
authors: Volpe
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: Carlos Eduardo
authors: CE
authors: Domene
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: Marco Aurélio
authors: MA
authors: Santo
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: Ivan
authors: I
authors: Cecconello
mesh_terms: D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D008875:Middle Aged; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery; D020535:Video-Assisted Surgery