Abstract
Rationale: Perioperative nutritional support via a surgically placed jejunostomy is commonly used in patients undergoing surgical resection of oesophago-gastric cancer. With the development of laparoscopic resectional techniques, is the use of jejunal feeding as safe as at open surgery? Methods: A prospective, comparative study of patients undergoing 2-stage oesophagectomy prior to and following the instigation of laparoscopic gastric mobilization and jejunostomy formation. End points assessed included major surgical complications, mechanical displacement and dislodgement and days of successful feeding. Results: 50 patients were assessed, 25 before and 25 after the change of practice (M:F ratio was 8:2, median age: 64 years). All had a successful insertion of jejunostomy and none had a significant surgical complication at time of insertion. Mechanical complications were similar between the 2 groups (8% in open surgery vs 12% in laparoscopic surgery) The mean number of days of nutritional support was also similar between the two sets of patients (medians with interquartile range) 39.6±42.35 days for open surgery and 19.6±13.21 days for laparoscopic insertion. Conclusion: Laparoscopically placed jejunostomies are as reliable and safe as those placed at open surgery for peri-operative nutritional support in patients undergoing oesophago-gastric cancer resection.
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