Nasojejunal Feeding Is Safe and Effective Alternative to Feeding Jejunostomy for Postoperative Enteral Nutrition in Gastric Cancer Patients

Kalita, Deepjyoti; Bannoth, Srinivas; Purkayastha, Joydeep; Borthakur, Bibhuti Bhusan; Talukdar, Anjan Kumar; Pegu, Niju; Das, Gaurav

doi:10.1055/s-0040-1721218

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…The majority of complications were related to the wounds themselves. Except for pulmonary complications, there were no statistically meaningful differences between the two clusters with respect to other potential complications, such as infection or seroma [17].…”

Section: Discussionmentioning

confidence: 76%

Comparison between Early and Standard Oral Feeding After Emergency Bowel Surgery

Khan¹,

Ahmad²,

Jamil³

et al. 2022

PJMHS

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Background: Laparotomy for small intestinal diseases accounts for a sizable proportion of all emergency operations. The perioperative outcome of these procedures may be enhanced by applying an adapted enhanced recovery after surgery (ERAS) regimen supported by evidence. Aim: This research aimed to appraise the outcomes of near-the-beginning feeding to those of normal eating in patients who had undergone emergency surgery on their digestive tracts (GI) or bowels. Methodology: This study was conducted at the departments of general surgery HMC Peshawar and Nishtar Hospital, Multan. Between November 2021 and April 2022, the data was collected from 84 patients who required emergency intestinal resection and anastomosis. Patients were not eligible if they had short bowel syndrome, intestinal ischemia, protracted bowel perforation, or septic shock. The patients were divided into two groups, those who began eating earlier (group E; n=44) and those who began eating later (group L; n=40). Early feeding entailed starting enteral nutrition within 48 hours of surgery. The surgical and clinical outcomes of the early feeding group were appraised to those of the late feeding cluster. Results: Bowel perforation was the most prevalent reason for surgery, and the miniature intestine was nearly all common areas affected. There was no meaningful difference in the origins, places, or interventions between the two sets of participants. Group L, on the other hand, had a much higher incidence of pulmonary issues (13.6 per cent vs 47.5 per cent, p=0.001) and an extended mean length of stay (LOS) in the ICU (2 days vs 1 day, p=0.038) and hospital (9 days vs 12 days, p=0.012).

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Section: Discussionmentioning

confidence: 76%

Comparison between Early and Standard Oral Feeding After Emergency Bowel Surgery

Khan¹,

Ahmad²,

Jamil³

et al. 2022

PJMHS

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“…Apart from minor complications there are reports of major complications including mortality from FJ tube and moreover patients with FJ tube who had complications had prolonged hospital stay with increased use of resources, thereby increases the overall costs. 6 The time for removal of NJ tube varies between 6 th to 15 th POD according to various studies depending upon protocol whereas time to removal of FJ tube is prolonged, around 6 th week. 6 The median time for NJ tube removal in our study is 10days, IQR (9-12).…”

Section: Resultsmentioning

confidence: 99%

“…6 The time for removal of NJ tube varies between 6 th to 15 th POD according to various studies depending upon protocol whereas time to removal of FJ tube is prolonged, around 6 th week. 6 The median time for NJ tube removal in our study is 10days, IQR (9-12). We have not done FJ after gastrectomy in any of our patients.…”

Section: Resultsmentioning

confidence: 99%

“…5 A study from India concluded that NJ route is the easiest technique, relatively safe, non-inferior to FJ for nutritional supplementation and less time taking with minor complications. 6 The aim of our study is to present our protocol of early enteral feeding using NJ tube and to convey the message that early feeding using NJ tube is simple, safe, cheap, easily manageable and has less complications. Flushing was done twice immediately after insertion and before closing the abdomen.…”

Section: Introductionmentioning

confidence: 99%

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Early enteral feeding using nasojejunal tube after gastric cancer surgery is safe and effective: a single unit experience from cancer hospital

et al. 2022

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Introduction: Patients are kept nil per oral (NPO) after surgery for gastric cancer and all patients receives intravenous fluids till oral feed is commenced. There is established benefit of enteral nutrition after surgery for gastric cancer. Early oral feeding comes with lots of hesitation for execution, so to offer benefits of early enteral nutrition and to avoid early oral feeding, nasojejunal tube (NJ) feeding can be used as alternative to feeding jejunostomy (FJ) and also total parenteral nutrition (TPN) can be avoided. The aim of this study is to present our experience of early enteral feeding using NJ tube and to convey the message that early feeding using NJ tube is safe, effective and has less complications. Methods: This is a retrospective study of patients operated between April 2019 to March 2022, who had nasojejunal tube placed at the time of surgery. NJ tube was placed in the efferent limb of jejunum. Feeding was started from post operative day 1 and gradually progressed over days. NJ tube was removed after adequate oral intake. Results: Sixty patients were eligible for final analysis. Median age of patients was 61 years, IQR (53-69). Thirty-three patients underwent D2-subtotal gastrectomy, 16 underwent D2-total gastrectomy and 10 underwent gastro-jejunostomy. Median time for discharge is 12 days, IQR (12-14). The median time for NJ removal is 10 days, IQR (9-12). Thirty-four patients reported complications related to NJ feed, all were minor and easily manageable. Conclusion: NJ tube feeding offers the advantages of early enteral feeding after gastric cancer surgery. It is technically easy to use and should be advocated for its simplicity, low costs and great advantages as compared to FJ and TPN.

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“…DSA-guided nasoenteric tube placement is relatively safe and reliable, serious complications are rare, and intraoperative imaging can identify the intestinal access after complex surgeries (19)(20)(21), as well as extensive abdominal metastasis and multiple intestinal strictures. By thorough analysis of cases of failed intubation (22)(23)(24), we can improve both preoperative preparation and intraoperative technique (25)(26)(27), thus improving the success rate and establishment of enteral nutrition in patients with malignant tumors.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the causes of failed placement of nasoenteric tube under DSA guidance and treatment strategies for successful re-catheterization

Yang¹,

Shi²,

Shen³

et al. 2022

Ann Palliat Med

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Background: For patients with advanced cancer or patients who have undergone digestive tract reconstruction, enteral nutrition is the most important nutritional support therapy, which can reduce the risk of enteral infection and improve self-immunity; while digital subtraction angiography (DSA) guided nasoenteric tube placement is suitable for nutritional support and palliative treatment of most patients with advanced cancer, many doctors because the preoperative preparation is not sufficient or the intraoperative operation is not standardized, resulting in catheter failure can not achieve the purpose of nutritional supply, and we need to summarize the lessons of failure and optimize the catheterization strategy.Methods: From February 2015 to July 2020, A total of 3,810 cases were treated with DSA guided nasoenteric feeding tube placement. According to the requirements that enteral nutrition could not be performed by the initial catheterization, 94 cases of catheterization failure were selected as the study subjects.The causes of catheterization failure were analyzed and summarized by analyzing the intraoperative image data and operation process; 42 cases of catheterization failure experienced successful catheterization after re-catheterization. By studying the relevant preoperative preparation and intraoperative operation, the treatment strategies and operation methods for successful re-catheterization were summarized.Results: In 94 patients with primary catheterization failure, anastomotic stenosis or obstruction accounted for 20.2%, excessive dilatation of gastric lumen accounted for 17.0%, pyloric stenosis or obstruction of antrum accounted for 13.8%, efferent loop stenosis or obstruction accounted for 11.7%, and the above factors were the main causes of DSA guided feeding tube failure; of the 42 patients with successful recatheterization, 9 patients underwent adequate negative pressure drainage before surgery, 7 patients modified the projection angle by adjusting the C-arm, 5 patients applied cone-beam CT technique, 5 patients used balloon dilatation of the stenotic segment, and the above factors were the main strategy methods for successful recatheterization. Conclusions:The success rate of DSA guided nasoenteric feeding tube placement will be greatly improved by adequate gastrointestinal decompression and drainage and other related preoperative preparation as well as good intraoperative application of cone-beam CT technique or combined application of balloon, gastroscope, stent and other technical means.

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Nasojejunal Feeding Is Safe and Effective Alternative to Feeding Jejunostomy for Postoperative Enteral Nutrition in Gastric Cancer Patients

Cited by 5 publications

References 13 publications

Comparison between Early and Standard Oral Feeding After Emergency Bowel Surgery

Comparison between Early and Standard Oral Feeding After Emergency Bowel Surgery

Early enteral feeding using nasojejunal tube after gastric cancer surgery is safe and effective: a single unit experience from cancer hospital

Analysis of the causes of failed placement of nasoenteric tube under DSA guidance and treatment strategies for successful re-catheterization

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