title: Laparoscopic jejunostomy for obstructing upper gastrointestinal malignancies.
abstract: The aim of this study was to describe a minimally invasive laparoscopic jejunostomy (Lap-J) technique for obstruction due to upper gastrointestinal malignancies and evaluate the nutritional benefit of Lap-J during neoadjuvant chemotherapy (NAC) in cases with obstructing esophageal cancer. Under general anesthesia, the jejunum 20-30 cm distant from the Treitz ligament was pulled out through an extended umbilical laparoscopic incision and a jejunal tube was inserted to 30 cm. The loop of bowel was gently returned to the abdomen and the feeding tube was drawn through the abdominal wall via the left lower incision. The jejunum was then laparoscopically sutured to the anterior abdominal wall. Lap-J was performed in 26 cases. The median operative time was 82 min. The postoperative course was uneventful. Lap-J prior to NAC was not associated with a decrease in body weight or serum total protein during NAC, compared with patients who received NAC without Lap-J. This minimally invasive jejunostomy technique may be particularly useful in patients in whom endoscopic therapy is not feasible due to obstruction from upper gastrointestinal malignancies.
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Tsujimoto
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hiraki
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Risa
authors.initials: R
authors.lastname: Takahata
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nomura
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Nozomi
authors.initials: N
authors.lastname: Ito
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Kyohei
authors.initials: K
authors.lastname: Kanematsu
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Horiguchi
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Suefumi
authors.initials: S
authors.lastname: Aosasa
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hase
keywords: enteral nutrition; esophageal cancer; laparoscopic jejunostomy; minimally invasive surgery