Abstract Background Malnutrition and weight-loss are correlated with higher mortality and morbidity in patients undergoing total gastrectomy(TG) for gastric cancers. The role of feeding jejunostomy(FJ) in the event of leak and extended use for postoperative nutritional support is much debated. There is a variation of practice in insertion, duration and monitoring of FJ and the evidence is sparse.This study presents the experience of a tertiary referral centre where the use of FJ is extended after TG with intention of delivery of home enteral tube feeding(HETF); its effect in reduced percentage weight-loss during post-operative and adjuvant chemotherapy period were evaluated. Methods A retrospective cohort study of patients who underwent total gastrectomy for gastric adenocarcinoma between January 2017 to June 2022 at a tertiary referral centre were included. Length of stay, post operative complications and complications associated with feeding jejunostomy insertion were assessed along with adjuvant chemotherapy data and percentage weight loss 12 months following TG. SPSS software was used with frequencies analysed by chi squared test and continuous variables by T test. All p values were two tailed and values less than 0.05 were considered significant. Results 82 patients who underwent TG were included; 37 had FJ inserted and 45 patients did not. Of the 37 FJ patients, 34 were discharged with HETF. Median duration of HETF was 127 days(56-428). HETF patients had a significantly reduced percentage weight-loss at 1-, 3- and 6-months post-TG. At 12-months, although reduced percentage of weight-loss in FJ group was observed, this was not statistically significant. Adherence and completion rate of adjuvant chemotherapy was higher in FJ group.There was no difference in length of stay and post-operative complications.11 FJ-related minor complications were reported.1 case of small bowel obstruction was managed conservatively. Conclusions The use of FJ with HETF post TG was safe, posing minimal complications. There is a significant reduction in percentage of weight loss in the first 6 months in the FJ group. This may indicate improved nutritional status and therefore better adherence and completion of adjuvant chemotherapy observed. The role of FJ spans beyond nutritional support in the event of anastomotic leak; extended use during adjuvant therapy period should be considered. Large scale controlled studies are required to further evaluate the benefits and cost-effectiveness.