Bowel obstruction associated with a feeding jejunostomy and its association to weight loss after thoracoscopic esophagectomy

Kitagawa, Hiroyuki; Namikawa, Tsutomu; Iwabu, Jun; Uemura, Sunao; Munekage, Masaya; Yokota, Keiichiro; Kobayashi, Mariko; Hanazaki, Kazuhiro

doi:10.1186/s12876-019-1029-6

Cited by 18 publications

(17 citation statements)

References 24 publications

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“…Furthermore, the suboptimal intake of nutrients could cause continuous weight loss which is considered as an independent risk factor for oncological prognosis. [26][27][28] According to the results, we found a high rate of anastomotic leakages in the MC group. One of the technical reasons for the high leakage rate could be due to resection of the tips of both the gastric conduit and esophagus which could cause more anastomotic tension.…”

Section: Discussionmentioning

confidence: 78%

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Modified Collardversusend‐to‐side hand‐sewn anastomosis for cervical anastomosis afterMcKeownesophagectomy

Cong

et al. 2020

Thoracic Cancer

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Background: According to previously published studies, esophagectomy with modified Collard anastomosis has been reported to have low incidences of anastomotic leak and stricture. However, the optional anastomotic method after esophagectomy is still controversial. We conducted this study to compare the incidence of postoperative anastomotic stricture formation and dysphagia over three years after an esophagectomy with modified Collard anastomosis (MC) or end-to-side (ETS) hand-sewn anastomosis. Meanwhile, the early postoperative anastomotic leakage and other complications, hospital stay and 30-and 90-day mortality were also evaluated. Methods: The clinical data of 905 patients undergoing McKeown esophagectomy were retrospectively reviewed. The rate of postoperative stricture formation after three years was demonstrated by stricture-free survival which is the primary end-point of this study. The incidence of dysphagia, first time of onset of stricture and number of dilatations were also recorded during follow-up. Results: The incidence of anastomotic leak tended to be higher in the MC group compared with that in the ETS group (13.0% vs. 8.7%, P = 0.064). The rates of anastomotic stricture in the MC group were significantly less than in the ETS group (P = 0.004). The number of dilatations in the MC group were significantly greater than those in the ETS group (2.34 vs. 2.46, P = 0.011). Conclusions: A modified Collard cervical esophagogastric anastomosis was associated with lower rates of anastomotic stricture and dysphagia, compared with ETS hand-sewn anastomosis. However, the modified Collard anastomosis is accompanied by an increased anastomotic leakage rate.

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Section: Discussionmentioning

confidence: 78%

“…The high rate of stricture and dysphagia in the ETS group could severely influence the oral nutritional supplements of the patients undergoing esophagectomy. Furthermore, the suboptimal intake of nutrients could cause continuous weight loss which is considered as an independent risk factor for oncological prognosis 26–28 …”

Section: Discussionmentioning

confidence: 99%

Modified Collardversusend‐to‐side hand‐sewn anastomosis for cervical anastomosis afterMcKeownesophagectomy

Cong

et al. 2020

Thoracic Cancer

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“…FJ may lead to complications such as dislodgement, clogging, leakage, bleeding, and small bowel obstruction [ 7 ]. A study conducted by Kitagawa et al had found that 17% of the patients who underwent thoracoscopic esophagectomy developed small bowel obstruction following FJ [ 8 ]. There is a literature report in which a patient had undergone FJ for lower-third esophageal carcinoma and later developed intussusception at the FJ site [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Massive Gastric Dilatation and Gastric Perforation as a Result of Closed-Loop Obstruction of the Stomach

Shaikh¹,

Chilaka²,

Reddy³

et al. 2021

Cureus

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Acute massive gastric dilatation is a rare event that is usually underdiagnosed. It can occur due to multiple etiologies, including medical and surgical, or as a postoperative complication. Acute massive gastric dilatation can lead to life-threatening fatal complications, including perforation, bleeding, or shock. We report a rare case of acute massive gastric dilatation with perforation of the stomach due to closed-loop obstruction of the stomach, which occurred in a patient with cricopharyngeal carcinoma due to a kink at the feeding jejunostomy site. Early diagnosis and treatment are essential, as acute massive gastric dilatation with perforation carries high morbidity and mortality.

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“…Kitagawa [ 25 ] mentioned lower adhesion formation after laparoscopic surgery as a potential risk factor for postoperative BOFJ and internal hernia. With gastric mobilization, a large intra-abdominal space is formed on the left side of the jejunostomy, into which the jejunum might invaginate and twist around the feeding jejunostomy.…”

Section: Discussionmentioning

confidence: 99%

Vertical distance from navel as a risk factor for bowel obstruction associated with feeding jejunostomy after esophagectomy: a retrospective cohort study

et al. 2020

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Background Placement of feeding jejunostomy (PFJ) during esophagectomy is an effective method to maintain adequate nutrition, but is associated with serious complications such as bowel obstruction and jejunal torsion. The purpose of the current study was to analyze the incidence, clinical features, and risk factors of bowel obstruction associated with feeding jejunostomy (BOFJ) after PFJ. Methods This was a retrospective cohort study of 70 patients who underwent esophagectomy with three-field lymph node dissection for esophageal cancer and treated with PFJ between March 2013 and December 2019 in our hospital. Abdominal dissection was performed under hand-assisted laparoscopic surgery (HALS) from March 2013 to March 2015, and was changed to complete laparoscopic surgery in April 2015. We compared patients with and without BOFJ, and the incidence of BOFJ was evaluated. The primary endpoint was incidence of BOFJ after PFJ. Results Six patients (8.5%) were diagnosed with BOFJ, all of whom were symptomatic and in the HALS group. In addition, 3 cases displayed histories of recurrent BOFJ (3, 3, and 5 times). Laparotomy was performed in all cases. Subgroup analysis of the HALS group showed a significant difference only in straight-line distance between the jejunostomy and navel as a significant pre- and perioperative factor (117 mm [101–130 mm] vs. 89 mm [51–150 mm], p < 0.001). Furthermore, dividing straight-line distance between the jejunostomy and navel into VD and HD, only VD differed significantly (107 mm [93–120 mm] vs. 79 mm [28–135 mm], p = 0.010), not HD (48 mm [40–59 mm] vs. 46 mm [22–60 mm], p = 0.199). Conclusions VD between the jejunostomy and navel was associated with BOFJ after PFJ with HALS esophagectomy. PFJ < 9 cm above the navel during HALS esophagectomy might effectively prevent BOFJ.

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Bowel obstruction associated with a feeding jejunostomy and its association to weight loss after thoracoscopic esophagectomy

Cited by 18 publications

References 24 publications

Modified Collardversusend‐to‐side hand‐sewn anastomosis for cervical anastomosis afterMcKeownesophagectomy

Modified Collardversusend‐to‐side hand‐sewn anastomosis for cervical anastomosis afterMcKeownesophagectomy

Acute Massive Gastric Dilatation and Gastric Perforation as a Result of Closed-Loop Obstruction of the Stomach

Vertical distance from navel as a risk factor for bowel obstruction associated with feeding jejunostomy after esophagectomy: a retrospective cohort study

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