TITLE:
Jejunostomy Feeding Tube Placement in Gastrectomy Procedures: A Systematic Review
AUTHORS:
Khalil Bazzi, John Lahoud, Charbel Sandroussi, Jerome Martin Laurence, Sharon Carey, David Yeo
KEYWORDS:
Gastrectomy, Jejunostomy, Feeding Jejunostomy Tube, Enteral Nutrition, Gastric Cancer
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.7 No.2,
February
15,
2017
ABSTRACT: Many nutritional interventions have been developed
to improve nutritional outcomes following upper gastrointestinal surgery. The
aim of this systematic review was to investigate whether or not the routine use
of intraoperative jejunostomy feeding tubes in partial and total gastrectomy
procedures is warranted when assessing complications and
nutritional benefits such as improved chemotherapy tolerance. An electronic
search of MEDLINE, Web of Science, Embase and CINAHL databases was performed to
identify studies which reported complications and/or post-operative outcomes of
patients who received an intraoperative jejunostomy feeding tube in gastrectomy
procedures. Five articles met the inclusion criteria (n = 636) with four retrospective cohort studies and one
RCT. Studies varied in regards to the complications and nutritional outcomes
reported. Jejunostomy feeding tube insertion may carry a risk of increased
infectious complications but appears to reduce patient post-operative
weight-loss and may improve chemotherapy tolerance. Due to the lack of
high-quality studies, it is unclear if the routine use of an intraoperative jejunostomy feeding tube is
indicated for all patients undergoing gastrectomy procedures or only those at a
high-risk of post-operative malnutrition. More comprehensive research is
recommended, particularly on the usefulness of home enteral nutrition
post-gastrectomy.