Single purse string suture feeding jejunostomy technique for enteral nutrition following corrosive ingestion

Abstract

Background: Maintaining nutrition in a corrosive poisoning patient is a challenging job. Despite other methods of enteral nutrition like nasogastric/naso jejunal tube, feeding gastrostomy –jejunostomy tube (JT) is most suitable for patients where esophagus and/or stomach is not available for enteral nutrition like esophageal carcinoma/gastric malignancy/ corrosive stricture esophagus. Methods: A single institution review of patients who underwent open JT placement between 2019 and 2022 was performed. Retrospectively data collected included demographics, operative technique and clinical outcomes. complications were analyzed postoperative period (<30 days) and in a long-term follow-up (>30 days). The Chi-square test was used to compare. Results: Operative time to create JT in single purse string is around average 26.96±3.22 minutes compared to double purse string is around 37.4±5.53 minute. During definitive surgery after approximately 6 month of history of corrosive ingestion easier and less time required to separate JT (14.96±3.03 minute) in single purse string compared to double purse string (20.48±3.88 minute) both result is significant. 8% (2 cases) JT site adhesion found in single purse string which is less compared to double purse string 36% (9 cases). Only 1 (4%) patient had JT site compromised bowel present in single purse string which is more in double purse string 10 cases (40%). Conclusions: The technique described here is safe and simple, and the overall tube-related morbidity is low. This procedure can be recommended in cases at risk for major morbidity and nutrition support needs.