Early postoperative enteral feeding by a needle catheter jejunostomy after 100 oesophageal resections and reconstructions for cancer

Abstract

After oesophageal resection and reconstruction oral feeding is excluded for a long period of time. Since dysphagia is found in most patients with an oesophageal cancer and therefore weight loss very common in these patients, early postoperative feeding seems logical. In the period between August 1980 and February 1983, needle catheter jejunostomy (NCJ) was introduced in 100 consecutive patients operated upon for oesophageal cancer. Reconstruction was performed in all patients during the same operation. Feeding was started in 97 patients, in 71% within 48 h postoperatively. Postoperative mortality was 9% in this group of patients, only one patient died possibly in relation to NCJ. Mean duration of feeding by NCJ was 15.6 days (range 2–84 days). Complications seen were diarrhoea (28%), intraperitoneal leakege (2%) and ileus (2%). Total number of feeding days in this group was 1502 days. Since NCJ feeding costs US $40 less than TPN per feeding day total savings for a 12 600 Joule intake was more than US $60 000. It is concluded that NCJ feeding is an economical and safe procedure after oesophageal resection and reconstruction for cancer.