Evaluation of a new technique for endoscopic nasojejunal feeding-tube placement

Abstract

Multiple techniques for endoscopic nasojejunal tube (NJT) placement exist. However, poor experience with these techniques has limited more routine practice of NJT placement for many endoscopists. We evaluated endoscopic NJT placement with a new stiff jejunal (J)-tube method (push technique). The GI Tract database at the Medical University of South Carolina was queried for NJT-placement procedures. Records of 42 patients who had undergone NJT placement by using the push technique between the years 2001 and 2004 at our institution were reviewed for information regarding procedure success and tube-related outcomes. The push technique of NJT placement was successful in 41 of 42 patients (97.6%), with an average procedure time of 11.6 minutes (range, 5-50 minutes). Negative outcomes occurred in 61% of properly positioned NJTs and included inadvertent tube removal by the patient or the staff (42.1%), dislodging (10.5%), clogging (5.3%), and kinking (5.3%). The average longevity of the NJT was 7.8 days (range, 1-37 days). Most patients were ultimately converted to a percutaneous enteral access device or to oral feedings. Endoscopic placement of NJT by using the push technique is an efficient, reliable method of accessing the small bowel for enteral nutrition.