TY - JOUR
T1 - Technical notes and outcomes of robot-assisted and laparoscopic jejunostomy placement for tube feeding after esophagectomy
AU - Feike Kingma, B.
AU - Turchi, Matias M.
AU - Lovera, Romina
AU - Ramirez, Mauricio
AU - Badaloni, Adolfo
AU - Van Hillegersberg, Richard
AU - Ruurda, Jelle P.
AU - Nieponice, Alejandro
N1 - Funding Information:
ICMJE uniform disclosure form (available at https:// aoe.amegroups.com/article/view/10.21037/aoe-21-4/ coif). The series “Anastomotic Techniques for Minimally Invasive Esophagectomy and Endoscopic Handling of Its Complications” was commissioned by the editorial office without any funding or sponsorship. AN served as an unpaid Guest Editor of the series and serves as an unpaid editorial board member of Annals of Esophagus from February 2020 to January 2022. RVH has received a clinical research grant from Intuitive Surgical Inc. and acts as a proctor for Intuitive Surgical Inc., outside the submitted work. JPR has received a clinical research grant from Intuitive Surgical Inc. and acts as a proctor for Intuitive Surgical Inc., outside the submitted work. The authors have no other conflicts of interest to declare.
Publisher Copyright:
© 2022 Journal of Innovation Management. All rights reserved.
PY - 2022/6
Y1 - 2022/6
N2 - Background: Recent studies reported considerable jejunostomy-related morbidity after esophagectomy, questioning the appropriateness of jejunostomy tube feeding for esophageal cancer patients. This study aimed to describe a technique for (robot-assisted) laparoscopic jejunostomy tube placement and to report its associated outcomes in patients undergoing minimally invasive esophagectomy (MIE). Methods: In this observational cohort study, patients who underwent MIE with (robot-assisted) laparoscopic jejunostomy tube placement were included from the prospective databases of two centers (2010-2019). Main endpoints included the incidence of jejunostomy-related complications, the duration of jejunostomy tube feeding, and weight change between surgery and 3- and 6-month follow-up. Patient characteristics were compared between patients who had jejunostomy-related complications versus patients who did not. Results: Jejunostomy-related complications occurred in 13 out of 93 patients (14%) and all involved infections. No intestinal torsions occurred in this cohort. Re-operation for jejunostomy-related infection was required in 1 patient (1%). Pre-existent comorbidity (100% vs. 71%, P=0.033), and diabetes mellitus in particular (31% vs. 9%, P=0.044), were significantly more common in patients with jejunostomy-related infections compared to patients without such complications. Jejunostomy tubes were removed earlier in patients with jejunostomy-related complications [median day 21 (IQR, 11-61) vs. day 37 (IQR, 28-72), P=0.049]. Conclusions: Minimally invasive jejunostomy tube placement with additional anti-rotation fixation, either robotically or laparoscopically, is a safe and advisable way of establishing the enteral feeding route in patients undergoing MIE.
AB - Background: Recent studies reported considerable jejunostomy-related morbidity after esophagectomy, questioning the appropriateness of jejunostomy tube feeding for esophageal cancer patients. This study aimed to describe a technique for (robot-assisted) laparoscopic jejunostomy tube placement and to report its associated outcomes in patients undergoing minimally invasive esophagectomy (MIE). Methods: In this observational cohort study, patients who underwent MIE with (robot-assisted) laparoscopic jejunostomy tube placement were included from the prospective databases of two centers (2010-2019). Main endpoints included the incidence of jejunostomy-related complications, the duration of jejunostomy tube feeding, and weight change between surgery and 3- and 6-month follow-up. Patient characteristics were compared between patients who had jejunostomy-related complications versus patients who did not. Results: Jejunostomy-related complications occurred in 13 out of 93 patients (14%) and all involved infections. No intestinal torsions occurred in this cohort. Re-operation for jejunostomy-related infection was required in 1 patient (1%). Pre-existent comorbidity (100% vs. 71%, P=0.033), and diabetes mellitus in particular (31% vs. 9%, P=0.044), were significantly more common in patients with jejunostomy-related infections compared to patients without such complications. Jejunostomy tubes were removed earlier in patients with jejunostomy-related complications [median day 21 (IQR, 11-61) vs. day 37 (IQR, 28-72), P=0.049]. Conclusions: Minimally invasive jejunostomy tube placement with additional anti-rotation fixation, either robotically or laparoscopically, is a safe and advisable way of establishing the enteral feeding route in patients undergoing MIE.
KW - artificial feeding
KW - Esophagectomy
KW - jejunostomy
KW - minimally invasive surgery
KW - robotics
UR - http://www.scopus.com/inward/record.url?scp=85131369432&partnerID=8YFLogxK
U2 - 10.21037/aoe-21-4
DO - 10.21037/aoe-21-4
M3 - Article
AN - SCOPUS:85131369432
VL - 5
SP - 1
EP - 11
JO - Annals of Esophagus
JF - Annals of Esophagus
M1 - 21
ER -