title: Clinical Burden of Laparoscopic Feeding Jejunostomy Tubes.
abstract: Feeding jejunostomies (J tubes) provide enteral nutrition when oral and gastric routes are not options. Despite their prevalence, there is a paucity of literature regarding their efficacy and clinical burden.
  
  
  
  All laparoscopic J tubes placed over a 5-year period were retrospectively reviewed. Clinical burden was measured by number of clinical contact events (tube-related clinic visits, phone calls, ED visits) and morbidity (dislodgement, clogging, tube fracture, infection, other). Tube replacements were also recorded.
  
  
  
  One hundred fifty-one patients were included. Fifty-nine percent had associated malignancy, and 35 % were placed for nutritional prophylaxis. Mean time to J tube removal was 146 days. J tubes were expected to be temporary in >90 % but only 50 % had sufficient oral intake for removal. Tubes were removed prematurely due to patient intolerance in 8 %. Mortality was 0 %. Morbidity was 51 % and included clogging (12 %), tube fracture (16 %), dislodgement (25 %), infection (18 %) and "other" (leaking, erosion, etc.) in 17 %. The median number of adverse events per J tube was 2(0-8). Mean number of clinic phone calls was 2.5(0-22), ED visits 0.5(0-7), and clinic visits 1.4(0-13), with 82 % requiring more than one J tube-related clinic visit. Unplanned replacements occurred in 40 %.
  
  
  
  While necessary for some patients, J tubes are associated with high clinical burden.
authors.affiliation: Department of Surgery, Providence Portland Medical Center, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Speer
authors.affiliation: Department of Surgery, Legacy Good Samaritan Hospital, 1040 NW 22nd Ave, Suite 520, Portland, OR, 97210, USA.
authors.forename: Simon C
authors.initials: SC
authors.lastname: Chow
authors.affiliation: Department of Surgery, Providence Portland Medical Center, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA. cdunst@orclinic.com.|Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA. cdunst@orclinic.com.|Foundation for Surgical Innovation and Education, 4805 NE Glisan St., Suite 6N60, Portland, OR, 97213, USA. cdunst@orclinic.com.
authors.forename: Christy M
authors.initials: CM
authors.lastname: Dunst
authors.affiliation: Department of Surgery, Providence Portland Medical Center, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA.
authors.forename: Amber L
authors.initials: AL
authors.lastname: Shada
authors.affiliation: Department of Surgery, Legacy Good Samaritan Hospital, 1040 NW 22nd Ave, Suite 520, Portland, OR, 97210, USA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Halpin
authors.affiliation: Department of Surgery, Providence Portland Medical Center, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA.|Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA.|Foundation for Surgical Innovation and Education, 4805 NE Glisan St., Suite 6N60, Portland, OR, 97213, USA.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Reavis
authors.affiliation: Department of Surgery, Providence Portland Medical Center, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA.|Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA.|Foundation for Surgical Innovation and Education, 4805 NE Glisan St., Suite 6N60, Portland, OR, 97213, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Cassera
authors.affiliation: Department of Surgery, Providence Portland Medical Center, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA.|Department of Surgery, Legacy Good Samaritan Hospital, 1040 NW 22nd Ave, Suite 520, Portland, OR, 97210, USA.|Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA.|Foundation for Surgical Innovation and Education, 4805 NE Glisan St., Suite 6N60, Portland, OR, 97213, USA.|Institut Hospitalo Universitaire Strasbourg, 1, Place de l'Hôpital, 97000, Strasbourg, France.
authors.forename: Lee L
authors.initials: LL
authors.lastname: Swanström
mesh_terms: D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation*; D007582:Jejunostomy / Q000009:adverse effects / Q000295:instrumentation*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D017211:Treatment Failure; D014481:United States / Q000453:epidemiology
keywords: Burden; Enteral nutrition; Feeding tube; Jejunostomy; Laparoscopic feeding jejunostomy; Laparoscopy