Experience with a simplified feeding jejunostomy technique for enteral nutrition following major visceral operations

Minarich, Michael J.; Schwarz, Roderich E.

doi:10.21037/tgh.2018.06.08

Cited by 5 publications

(2 citation statements)

References 35 publications

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“…Surgical jejunostomy is an effective approach providing enteral access for early enteral nutrition and to deliver medications in the postoperative period. This technique is also useful to have a prolonged enteral access in patients who develop surgical complications [51,52]. Radiologic jejunostomy was also addressed by some authors as a non-surgical alternative; however, the available data are still limited [53].…”

Section: Surgical Jejunostomymentioning

confidence: 99%

Nutritional Support of Cancer Patients without Oral Feeding: How to Select the Most Effective Technique?

Nunes

Fonseca

Barata

et al. 2019

GE Port J Gastroenterol

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Background: Digestive tumours are among the leading causes of morbidity and mortality. Many cancer patients cannot maintain oral feeding and develop malnutrition. The authors aim to: review the endoscopic, radiologic and surgical techniques for nutritional support in cancer patients; address the strategies for nutritional intervention according to the selected technique; and establish a decision-making algorithm to define the best approach in a specific tumour setting. Summary: This is a narrative non-systematic review based on an electronic search through the medical literature using PubMed and UpToDate. The impossibility of maintaining oral feeding is a major cause of malnutrition in head and neck (H&N) cancer, oesophageal tumours and malignant gastric outlet obstruction. Tube feeding, endoscopic stents and gastrojejunostomy are the three main nutritional options. Nasal tubes are indicated for short-term enteral feeding. Percutaneous endoscopic gastrostomy (PEG) is the gold standard when enteral nutrition is expected for more than 3-4 weeks, especially in H&N tumour and oesophageal cancer patients undergoing definite chemoradiotherapy. A gastropexy push system may be considered to avoid cancer seeding. Radiologic and surgical gastrostomy are alternatives when an endoscopic approach is not feasible. Postpyloric nutrition is indicated for patients intolerant to gastric feeding and may be achieved through nasoenteric tubes, PEG with jejunal extension, percutaneous endoscopic jejunostomy and surgical jejunostomy. Oesophageal and enteric stents are palliative techniques that allow oral feeding and improve quality of life. Surgical or EUS-guided gastrojejunostomy is recommended when enteric stents fail or prolonged survival is expected. Nutritional intervention is dependent on the technique chosen. Institutional protocols and decision algorithms should be developed on a multidisciplinary basis to optimize nutritional care. Conclusions: Gastroenterologists play a central role in the nutritional support of cancer patients performing endoscopic techniques that maintain oral or enteral feeding. The selection of the most effective technique must consider the cancer type, the oncologic therapeutic program, nutritional aims and expected patient survival.

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Section: Surgical Jejunostomymentioning

confidence: 99%

Nutritional Support of Cancer Patients without Oral Feeding: How to Select the Most Effective Technique?

Nunes

Fonseca

Barata

et al. 2019

GE Port J Gastroenterol

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“…Among the factors contributing to the low quality of life of patients during the perioperative period, postoperative ileus (POI) is the main influencing factor (2). POI could cause abdominal distension, nausea, pain, and delayed defecation time, and affect intestinal function recovery, prolong hospital stay, and increase economic burden on the patient (3).…”

Section: Introductionmentioning

confidence: 99%

Impact of perioperative intravenous lidocaine infusion on postoperative pain and rapid recovery of patients undergoing gastrointestinal tumor surgery: a randomized, double-blind trial

Dai¹,

Jiang²,

Su³

et al. 2020

J Gastrointest Oncol

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Background: To explore the effect of perioperative intravenous lidocaine infusion on postoperative pain and the rapid recovery of patients undergoing gastrointestinal tumor surgery. Methods: The patients who underwent gastrointestinal tumor surgery from May to July 2020 were selected. The patients were randomly divided into the lidocaine group (group L) and control group (group C) by the random number table method, with 60 patients in each group. Both groups of patients received an intravenous drug infusion immediately after induction of tracheal intubation under general anesthesia.In group L, 1.5 mg/kg lidocaine was slowly injected intravenously at a rate of 1.5 mg•kg -1•h -1 to the surgical suture, and intravenous inhalation was used to maintain the depth of anesthesia. Group C patients were given the same volume of normal saline. The 2-, 4-, 7-, 14-, 30-, and 90-day numerical rating scale (NRS)and the proportion of chronic post-surgical pain (CPSP) after 3 months for both groups after surgery were recorded. Each patient's postoperative comfort score, requiring analgesia, return of flatus, bowl movement, hospitalization days, hospitalization expenses, and adverse events were also recorded.Results: One hundred and twenty patients were enrolled but 5 of them failed to complete the treatment process. Therefore, 58 and 57 patients in group L and C were included into the final analysis. The NRS of patients in group L was significantly lower than that of group C at all time points after surgery (P<0.05), and the proportion of CPSP in group L was significantly lower than that of group C (P<0.05). The percentage of patients requiring analgesia and postoperative comfort score of group L was significantly higher than that of group C (P<0.01), patient's return of flatus, bowl movement, hospitalization days, and hospitalization expenses in group L were significantly lower than those in group C (P<0.05). There were no difference of adverse events between the 2 groups (P>0.05).Conclusions: During the perioperative period of radical gastrointestinal tumor surgery, intravenous lidocaine infusion can reduce acute postoperative pain, promote postoperative gastrointestinal function recovery, and improve postoperative comfort.

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Gastrointestinal carcinoma and sarcoma surgery

Koniaris

2019

Transl. Gastroenterol. Hepatol

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Experience with a simplified feeding jejunostomy technique for enteral nutrition following major visceral operations

Abstract: The technique described is safe and expedient, and the overall tube-related morbidity is low. This procedure can be recommended in cases at risk for major morbidity and nutrition support needs.

Cited by 5 publications

References 35 publications

Nutritional Support of Cancer Patients without Oral Feeding: How to Select the Most Effective Technique?

Nutritional Support of Cancer Patients without Oral Feeding: How to Select the Most Effective Technique?

Impact of perioperative intravenous lidocaine infusion on postoperative pain and rapid recovery of patients undergoing gastrointestinal tumor surgery: a randomized, double-blind trial

Gastrointestinal carcinoma and sarcoma surgery

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