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Dan G Blazer - One of the best experts on this subject based on the ideXlab platform.
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feeding Jejunostomy Tube placement during resection of gastric cancers
Journal of Surgical Research, 2016Co-Authors: Zhifei Sun, Mithun Shenoi, Daniel P Nussbaum, Jeffrey E Keenan, Brian C Gulack, Douglas S Tyler, Paul J Speicher, Dan G BlazerAbstract:Abstract Background Feeding Tube placement is common among patients undergoing gastrectomy, and national guidelines currently recommend consideration of a feeding Jejunostomy Tube (FJT) for all patients undergoing resection for gastric cancer. However, data are limited regarding the safety of FJT placement at the time of gastrectomy for gastric cancer. Methods The 2005–2011 American College of Surgeons National Surgical Quality Improvement Program Participant User Files were queried to identify patients who underwent gastrectomy for gastric cancer. Subjects were classified by the concomitant placement of an FJT. Groups were then propensity matched using a 1:1 nearest neighbor algorithm, and outcomes were compared between groups. The primary outcomes of interest were overall 30-d overall complications and mortality. Secondary end points included major complications, surgical site infection, and early reoperation. Results In total, 2980 subjects underwent gastrectomy for gastric cancer, among whom 715 (24%) also had an FJT placed. Patients who had an FJT placed were more likely to be male (61.6% versus 56.6%, P = 0.02), have recent weight loss (21.0% versus 14.8%, P versus 4.2%, P versus 1.3%, P versus 28.6%, P versus 24.1%, P versus 36.1%, P = 0.32) or mortality (5.8 versus 3.7%, P = 0.08). There were also no differences in major complications, surgical site infection, or early reoperation. Operative time was slightly longer among patients with feeding Tubes placed (median, 248 versus 233 min, P = 0.01), but otherwise there were no significant differences in any outcomes between groups. Conclusions Concomitant placement of FJT at the time of gastrectomy may result in slightly increased operative times but does not appear to lead to increased perioperative morbidity or mortality. Further investigation is needed to identify the patients most likely to benefit from FJT placement.
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Feeding Jejunostomy Tube Placement in Patients Undergoing Pancreaticoduodenectomy: An Ongoing Dilemma
Journal of Gastrointestinal Surgery, 2014Co-Authors: Daniel P Nussbaum, Sabino Zani, Douglas S Tyler, Paul J Speicher, Kara Penne, Sandra S. Stinnett, Bryan M. Clary, Rebekah R. White, Dan G BlazerAbstract:Background Concomitant placement of feeding Jejunostomy Tubes (FJT) during pancreaticoduodenectomy is common, yet there are limited data regarding catheter-specific morbidity and associated outcomes. This information is crucial to appropriately select patients for feeding Tube placement and to optimize perioperative nutrition strategies. Methods A review of all patients undergoing pancreaticoduodenectomy with FJT placement was completed. Patients were grouped by the occurrence of FJT-related morbidity. Multivariable logistic regression was performed to identify predictors of FJT morbidity; these complications were then further defined. Finally, associated postoperative outcomes were compared between groups. Results In total, 126 patients were included, of which 18 (14 %) had complications directly related to their FJT, including pericatheter infection ( n = 6), pneumatosis intestinalis ( n = 4), severe Tube feed intolerance ( n = 3), and primary catheter malfunction ( n = 7). Following adjustment with logistic regression, preoperative hypoalbuminemia was identified as the only independent predictor of FJT complications (OR 2.23, p = 0.035). Patients with FJT complications were more likely to be initiated on total parenteral nutrition (TPN; 55.6 vs. 7.4 %, p −0.035) and to require TPN at discharge (16.7 vs. 0 %, p = 0.003). Correspondingly, these patients resumed an oral diet later (14 vs. 8 days, p = 0.06). Both reoperation (50.0 vs. 6.5 %, p
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feeding Jejunostomy Tube placement in patients undergoing pancreaticoduodenectomy an ongoing dilemma
Journal of Gastrointestinal Surgery, 2014Co-Authors: Daniel P Nussbaum, Sabino Zani, Douglas S Tyler, Paul J Speicher, Kara Penne, Sandra S. Stinnett, Bryan M. Clary, Rebekah R. White, Dan G BlazerAbstract:Background Concomitant placement of feeding Jejunostomy Tubes (FJT) during pancreaticoduodenectomy is common, yet there are limited data regarding catheter-specific morbidity and associated outcomes. This information is crucial to appropriately select patients for feeding Tube placement and to optimize perioperative nutrition strategies.
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feeding Jejunostomy during whipple is associated with increased morbidity
Journal of Surgical Research, 2014Co-Authors: James Padussis, Sabino Zani, Douglas S Tyler, Dan G Blazer, Theodore N Pappas, John E ScarboroughAbstract:Abstract Background Placement of a feeding Jejunostomy Tube (FJ) is often performed during pancreaticoduodenectomy (PD). Few studies, however, have sought to determine whether such placement affects postoperative outcomes after PD. Materials and methods This is a retrospective analysis of the National Surgical Quality Improvement Program (NSQIP) database to determine the 30-d-postoperative mortality rate, major complication rate, and overall complication rate of Jejunostomy Tube placement at the time of PD. Univariate and multivariate comparison of postoperative outcomes between patients with and without FJ placement during PD was performed on a total of 4930 patients. Results Thirty-day-postoperative mortality did not differ between the two groups (4.0% for patients with FJ versus 2.7% without, P = 0.13), whereas overall morbidity (43.3% with FJ versus 34.6% without, P Conclusion Although FJ placement during PD is considered to be routine at many institutions, our analysis of data from NSQIP suggest that FJ placement may be associated with increased postoperative morbidity.
Richard Van Hillegersberg - One of the best experts on this subject based on the ideXlab platform.
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Does Jejunostomy Tube Feeding Improve Outcomes After Esophagectomy
Difficult Decisions in Surgery: An Evidence-Based Approach, 2020Co-Authors: B. Feike Kingma, Jelle P. Ruurda, Richard Van HillegersbergAbstract:Oral intake is traditionally prohibited for the first few days after esophagectomy. To ensure sufficient nutritional intake, various feeding strategies are applied worldwide. Although the quality of available evidence is limited, Jejunostomy Tube feeding is recommended over nasoenteric Tube feeding or total parenteral nutrition based on this literature review. Furthermore, in case an early oral feeding regimen is desired, the placement of a standby Jejunostomy Tube is advised in order to allow immediate enteral nutrition support in case oral intake is insufficient or contraindicated because of complications.
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postoperative complications and weight loss following Jejunostomy Tube feeding after total gastrectomy for advanced adenocarcinomas
Chinese Journal of Cancer Research, 2017Co-Authors: Hylke J. F. Brenkman, Jelle P. Ruurda, Elles Steenhagen, Stéphanie V.s. Roelen, Richard Van HillegersbergAbstract:Objective: Patients undergoing total gastrectomy for cancer are at risk of malnourishment. The aim of this selfcontrolled study was to examine the effect of Jejunostomy Tube feeding (JTF) and other factors on postoperative weight and the incidence of Jejunostomy-related complications in patients undergoing total gastrectomy for cancer. Methods: All consecutive patients who underwent total gastrectomy for gastric cancer with Jejunostomy placement were included from a prospective single-center database (2003–2014). Jejunostomy-related complications and postoperative weight changes were evaluated up to 12 months after surgery. Multivariable linear regression analysis was performed to identify factors associated with weight loss 12 months after gastrectomy. Results: Of 113 patients operated in the study period, 65 received JTF after total gastrectomy for a median duration of 18 d [interquartile range (IQR), 10–55 d]. Jejunostomy-related complications occurred in 11 (17%) patients, including skin leakage (n=3) and peritoneal leakage (n=2), luxation (n=3), occlusion (n=2), infection (n=1) and torsion (n=1). In 2 (3%) patients, a reoperation was needed due to Jejunostomy-related complications. The mean preoperative weight of patients was 71.8 kg (100%), and remained stable during JTF (73.9 kg, 103%, P=0.331). After JTF was stopped, the mean weight of patients decreased to 64.9 kg (90%) at 12 months after surgery (P<0.001). A high preoperative body mass index (BMI) (≥25 kg/m2) was associated with high postoperative weight loss compared to patients with a low BMI (<25 kg/m2) (16.3% vs. 8.6%, P=0.016). Conclusions: JTF can prevent weight loss in the early postoperative phase. However, this is at the prize of possible complications. As weight loss in the long term is not prevented, routine JTF should be re-evaluated and balanced against the selected use in preoperatively malnourished patients. Special attention should be paid to patients with a high preoperative BMI, who are at risk of more postoperative weight loss.
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Routine Jejunostomy Tube feeding following esophagectomy.
Journal of Thoracic Disease, 2017Co-Authors: Teus J. Weijs, Hanneke W.j. Van Eden, Jelle P. Ruurda, Misha D. P. Luyer, Elles Steenhagen, Grard A. P. Nieuwenhuijzen, Richard Van HillegersbergAbstract:Background: Malnutrition is an important problem following esophagectomy. A surgically placed Jejunostomy secures an enteral feeding route, facilitating discharge with home-Tube feeding and long-term nutritional support. However, specific complications occur, and data are lacking that support its use over other enteral feeding routes. Therefore routine Jejunostomy Tube feeding and discharge with home-Tube feeding was evaluated, with emphasis on weight loss, length of stay and re-admissions. Methods: Consecutive patients undergoing esophagectomy for cancer, with gastric Tube reconstruction and Jejunostomy creation, were analyzed. Two different regimens were compared. Before January 07, 2011 patients were discharged when oral intake was sufficient, without Tube feeding. After that discharge with home-Tube feeding was routinely performed. Logistic regression analysis corrected for confounders. Results: Some 236 patients were included. The median duration of Tube feeding was 35 days. Reoperation for a Jejunostomy-related complication was needed in 2%. The median body mass index (BMI) remained stable during Tube feeding. The BMI decreased significantly after stopping Tube feeding: from 25.6 (1st–3rd quartile 23.0–28.6) kg/m2 to 24.4 (22.0–27.1) kg/m2 at 30 days later [median weight loss: 3.0 (1.0–5.3) kg; 3.9% (1.5–6.3%)]. Weight loss was not affected by the duration of Tube feeding duration. Routine home-Tube feeding did not affect weight loss, admission time or the readmission rate. Conclusions: Weight loss following esophagectomy occurs once that Tube feeding is stopped, independently from the time interval after esophagectomy. Moreover routine discharge with home-Tube feeding does not reduce length of stay or readmissions. These findings question the value of routine Jejunostomy placement and emphasize the need for further research.
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Routine Jejunostomy Tube feeding following esophagectomy.
Journal of thoracic disease, 2017Co-Authors: Teus J. Weijs, Hanneke W.j. Van Eden, Jelle P. Ruurda, Misha D. P. Luyer, Elles Steenhagen, Grard A. P. Nieuwenhuijzen, Richard Van HillegersbergAbstract:Malnutrition is an important problem following esophagectomy. A surgically placed Jejunostomy secures an enteral feeding route, facilitating discharge with home-Tube feeding and long-term nutritional support. However, specific complications occur, and data are lacking that support its use over other enteral feeding routes. Therefore routine Jejunostomy Tube feeding and discharge with home-Tube feeding was evaluated, with emphasis on weight loss, length of stay and re-admissions. Consecutive patients undergoing esophagectomy for cancer, with gastric Tube reconstruction and Jejunostomy creation, were analyzed. Two different regimens were compared. Before January 07, 2011 patients were discharged when oral intake was sufficient, without Tube feeding. After that discharge with home-Tube feeding was routinely performed. Logistic regression analysis corrected for confounders. Some 236 patients were included. The median duration of Tube feeding was 35 days. Reoperation for a Jejunostomy-related complication was needed in 2%. The median body mass index (BMI) remained stable during Tube feeding. The BMI decreased significantly after stopping Tube feeding: from 25.6 (1st-3rd quartile 23.0-28.6) kg/m2 to 24.4 (22.0-27.1) kg/m2 at 30 days later [median weight loss: 3.0 (1.0-5.3) kg; 3.9% (1.5-6.3%)]. Weight loss was not affected by the duration of Tube feeding duration. Routine home-Tube feeding did not affect weight loss, admission time or the readmission rate. Weight loss following esophagectomy occurs once that Tube feeding is stopped, independently from the time interval after esophagectomy. Moreover routine discharge with home-Tube feeding does not reduce length of stay or readmissions. These findings question the value of routine Jejunostomy placement and emphasize the need for further research.
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Postoperative complications and weight loss following Jejunostomy Tube feeding after total gastrectomy for advanced adenocarcinomas.
Chinese journal of cancer research = Chung-kuo yen cheng yen chiu, 2017Co-Authors: Hylke J. F. Brenkman, Jelle P. Ruurda, Elles Steenhagen, Stéphanie V.s. Roelen, Richard Van HillegersbergAbstract:Objective: Patients undergoing total gastrectomy for cancer are at risk of malnourishment. The aim of this selfcontrolled study was to examine the effect of Jejunostomy Tube feeding (JTF) and other factors on postoperative weight and the incidence of Jejunostomy-related complications in patients undergoing total gastrectomy for cancer. Methods: All consecutive patients who underwent total gastrectomy for gastric cancer with Jejunostomy placement were included from a prospective single-center database (2003–2014). Jejunostomy-related complications and postoperative weight changes were evaluated up to 12 months after surgery. Multivariable linear regression analysis was performed to identify factors associated with weight loss 12 months after gastrectomy. Results: Of 113 patients operated in the study period, 65 received JTF after total gastrectomy for a median duration of 18 d [interquartile range (IQR), 10–55 d]. Jejunostomy-related complications occurred in 11 (17%) patients, including skin leakage (n=3) and peritoneal leakage (n=2), luxation (n=3), occlusion (n=2), infection (n=1) and torsion (n=1). In 2 (3%) patients, a reoperation was needed due to Jejunostomy-related complications. The mean preoperative weight of patients was 71.8 kg (100%), and remained stable during JTF (73.9 kg, 103%, P=0.331). After JTF was stopped, the mean weight of patients decreased to 64.9 kg (90%) at 12 months after surgery (P
Jeffrey L Ponsky - One of the best experts on this subject based on the ideXlab platform.
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comparison of laparoscopic Jejunostomy Tube to percutaneous endoscopic gastrostomy Tube with jejunal extension long term durability and nutritional outcomes
Surgical Endoscopy and Other Interventional Techniques, 2018Co-Authors: Ivy N Haskins, Andrew T Strong, Gautam Sharma, John Rodriguez, Jeffrey L Ponsky, Mary Baginsky, Matthew Karafa, Matthew KrohAbstract:Enteral access through the jejunum is indicated when patients cannot tolerate oral intake or gastric feeding. While multiple approaches for feeding jejunal access exist, few studies have compared the efficacy of these techniques. The purpose of this study was to investigate the long-term durability, re-intervention rates, and nutritional outcomes following percutaneous endoscopic gastrostomy Tubes with jejunal extension Tubes (PEG-JET) versus laparoscopic Jejunostomy Tubes (j-Tubes). Retrospective chart review was performed on all patients who underwent PEG-JET or laparoscopic Jejunostomy Tube placement from January 2005 through December 2015 at our institution. Thirty-day and long-term outcomes were compared between the two groups. A total of 105 patients underwent PEG-JET and 307 patients underwent laparoscopic j-Tube placement during the defined study period. In terms of 30-day outcomes, patients who underwent PEG-JET placement were significantly more likely to experience a Tube dislodgement event (p = 0.005) and undergo a re-intervention (p < 0.001). Patients who had a laparoscopic j-Tube placed were significantly more likely to meet their enteral feeding goals (p = 0.002) and less likely to require nutritional supplementation with total parenteral nutrition (TPN) (p < 0.001). With regard to long-term outcomes, patients who underwent PEG-JET placement were significantly more likely to experience Tube occlusion (p < 0.001) and require an endoscopic or surgical Tube re-intervention (p < 0.001). Patients who underwent laparoscopic j-Tube placement were significantly more likely to experience a Tube site leak (p = 0.015) but were less likely to require nutritional supplementation with TPN (p = 0.001). Laparoscopic Jejunostomy Tubes provide more durable long-term enteral access compared to PEG-JET. Consideration should be given to laparoscopic Jejunostomy Tube placement in eligible patients who cannot tolerate oral intake or gastric enteral feeding.
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Comparison of laparoscopic Jejunostomy Tube to percutaneous endoscopic gastrostomy Tube with jejunal extension: long-term durability and nutritional outcomes.
Surgical endoscopy, 2017Co-Authors: Ivy N Haskins, Andrew T Strong, Gautam Sharma, John Rodriguez, Jeffrey L Ponsky, Mary Baginsky, Matthew Karafa, Matthew KrohAbstract:Enteral access through the jejunum is indicated when patients cannot tolerate oral intake or gastric feeding. While multiple approaches for feeding jejunal access exist, few studies have compared the efficacy of these techniques. The purpose of this study was to investigate the long-term durability, re-intervention rates, and nutritional outcomes following percutaneous endoscopic gastrostomy Tubes with jejunal extension Tubes (PEG-JET) versus laparoscopic Jejunostomy Tubes (j-Tubes). Retrospective chart review was performed on all patients who underwent PEG-JET or laparoscopic Jejunostomy Tube placement from January 2005 through December 2015 at our institution. Thirty-day and long-term outcomes were compared between the two groups. A total of 105 patients underwent PEG-JET and 307 patients underwent laparoscopic j-Tube placement during the defined study period. In terms of 30-day outcomes, patients who underwent PEG-JET placement were significantly more likely to experience a Tube dislodgement event (p = 0.005) and undergo a re-intervention (p
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direct percutaneous endoscopic Jejunostomy dpej Tube placement a single institution experience and outcomes to 30 days and beyond
Journal of Gastrointestinal Surgery, 2017Co-Authors: Andrew T Strong, Gautam Sharma, Matthew Davis, Michael Mulcahy, Suriya Punchai, Colin Orourke, Stacy A Brethauer, John Rodriguez, Jeffrey L PonskyAbstract:Introduction Patients with prior foregut surgery requiring long-term enteral access typically undergo operative Jejunostomy Tube placement; however, direct percutaneous endoscopic Jejunostomy (DPEJ) is a viable alternative.
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Direct Percutaneous Endoscopic Jejunostomy (DPEJ) Tube Placement: A Single Institution Experience and Outcomes to 30 Days and Beyond
Journal of Gastrointestinal Surgery, 2017Co-Authors: Andrew T Strong, Gautam Sharma, Matthew Davis, Michael Mulcahy, Suriya Punchai, Stacy A Brethauer, John Rodriguez, Jeffrey L Ponsky, Colin P. O’rourke, Matthew D. KrohAbstract:Introduction Patients with prior foregut surgery requiring long-term enteral access typically undergo operative Jejunostomy Tube placement; however, direct percutaneous endoscopic Jejunostomy (DPEJ) is a viable alternative. Methods All de novo DPEJ procedures performed by surgical and advanced endoscopists from May 2003 to June 2015 were retrospectively reviewed following approval by the Institutional Review Board. There were 59 cases identified. Results Our cohort had a mean age of 50.3 ± 16.9 years and 35 (59.3%) were female. All but two patients previously had foregut surgery including 19 patients (34.5%) with prior bariatric surgery. The composite of malnutrition and dehydration was the indication for DPEJ in 29 patients (49.1%) and was the initial enteral access placed in 47 patients (79.7%). Moderate sedation was used in 32 cases (54.2%), and 29 procedures (49.2%) were performed in the operating room. Within 30 days, there were six complications in five patients, giving a peri-procedural complication rate of 12.5%. Beyond 30 days, the most common complications were peri-Tube leakage and dislodgement (each 16.9%). The median time to complication was 197 days. Conclusions In patients with surgically altered foregut anatomy, DPEJ offers a less invasive alternative to operative Jejunostomy Tube placement. DPEJ can be placed in the endoscopy suite or operating room with an acceptable risk of perioperative complications.
Douglas S Tyler - One of the best experts on this subject based on the ideXlab platform.
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feeding Jejunostomy Tube placement during resection of gastric cancers
Journal of Surgical Research, 2016Co-Authors: Zhifei Sun, Mithun Shenoi, Daniel P Nussbaum, Jeffrey E Keenan, Brian C Gulack, Douglas S Tyler, Paul J Speicher, Dan G BlazerAbstract:Abstract Background Feeding Tube placement is common among patients undergoing gastrectomy, and national guidelines currently recommend consideration of a feeding Jejunostomy Tube (FJT) for all patients undergoing resection for gastric cancer. However, data are limited regarding the safety of FJT placement at the time of gastrectomy for gastric cancer. Methods The 2005–2011 American College of Surgeons National Surgical Quality Improvement Program Participant User Files were queried to identify patients who underwent gastrectomy for gastric cancer. Subjects were classified by the concomitant placement of an FJT. Groups were then propensity matched using a 1:1 nearest neighbor algorithm, and outcomes were compared between groups. The primary outcomes of interest were overall 30-d overall complications and mortality. Secondary end points included major complications, surgical site infection, and early reoperation. Results In total, 2980 subjects underwent gastrectomy for gastric cancer, among whom 715 (24%) also had an FJT placed. Patients who had an FJT placed were more likely to be male (61.6% versus 56.6%, P = 0.02), have recent weight loss (21.0% versus 14.8%, P versus 4.2%, P versus 1.3%, P versus 28.6%, P versus 24.1%, P versus 36.1%, P = 0.32) or mortality (5.8 versus 3.7%, P = 0.08). There were also no differences in major complications, surgical site infection, or early reoperation. Operative time was slightly longer among patients with feeding Tubes placed (median, 248 versus 233 min, P = 0.01), but otherwise there were no significant differences in any outcomes between groups. Conclusions Concomitant placement of FJT at the time of gastrectomy may result in slightly increased operative times but does not appear to lead to increased perioperative morbidity or mortality. Further investigation is needed to identify the patients most likely to benefit from FJT placement.
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Feeding Jejunostomy Tube Placement in Patients Undergoing Pancreaticoduodenectomy: An Ongoing Dilemma
Journal of Gastrointestinal Surgery, 2014Co-Authors: Daniel P Nussbaum, Sabino Zani, Douglas S Tyler, Paul J Speicher, Kara Penne, Sandra S. Stinnett, Bryan M. Clary, Rebekah R. White, Dan G BlazerAbstract:Background Concomitant placement of feeding Jejunostomy Tubes (FJT) during pancreaticoduodenectomy is common, yet there are limited data regarding catheter-specific morbidity and associated outcomes. This information is crucial to appropriately select patients for feeding Tube placement and to optimize perioperative nutrition strategies. Methods A review of all patients undergoing pancreaticoduodenectomy with FJT placement was completed. Patients were grouped by the occurrence of FJT-related morbidity. Multivariable logistic regression was performed to identify predictors of FJT morbidity; these complications were then further defined. Finally, associated postoperative outcomes were compared between groups. Results In total, 126 patients were included, of which 18 (14 %) had complications directly related to their FJT, including pericatheter infection ( n = 6), pneumatosis intestinalis ( n = 4), severe Tube feed intolerance ( n = 3), and primary catheter malfunction ( n = 7). Following adjustment with logistic regression, preoperative hypoalbuminemia was identified as the only independent predictor of FJT complications (OR 2.23, p = 0.035). Patients with FJT complications were more likely to be initiated on total parenteral nutrition (TPN; 55.6 vs. 7.4 %, p −0.035) and to require TPN at discharge (16.7 vs. 0 %, p = 0.003). Correspondingly, these patients resumed an oral diet later (14 vs. 8 days, p = 0.06). Both reoperation (50.0 vs. 6.5 %, p
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feeding Jejunostomy Tube placement in patients undergoing pancreaticoduodenectomy an ongoing dilemma
Journal of Gastrointestinal Surgery, 2014Co-Authors: Daniel P Nussbaum, Sabino Zani, Douglas S Tyler, Paul J Speicher, Kara Penne, Sandra S. Stinnett, Bryan M. Clary, Rebekah R. White, Dan G BlazerAbstract:Background Concomitant placement of feeding Jejunostomy Tubes (FJT) during pancreaticoduodenectomy is common, yet there are limited data regarding catheter-specific morbidity and associated outcomes. This information is crucial to appropriately select patients for feeding Tube placement and to optimize perioperative nutrition strategies.
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feeding Jejunostomy during whipple is associated with increased morbidity
Journal of Surgical Research, 2014Co-Authors: James Padussis, Sabino Zani, Douglas S Tyler, Dan G Blazer, Theodore N Pappas, John E ScarboroughAbstract:Abstract Background Placement of a feeding Jejunostomy Tube (FJ) is often performed during pancreaticoduodenectomy (PD). Few studies, however, have sought to determine whether such placement affects postoperative outcomes after PD. Materials and methods This is a retrospective analysis of the National Surgical Quality Improvement Program (NSQIP) database to determine the 30-d-postoperative mortality rate, major complication rate, and overall complication rate of Jejunostomy Tube placement at the time of PD. Univariate and multivariate comparison of postoperative outcomes between patients with and without FJ placement during PD was performed on a total of 4930 patients. Results Thirty-day-postoperative mortality did not differ between the two groups (4.0% for patients with FJ versus 2.7% without, P = 0.13), whereas overall morbidity (43.3% with FJ versus 34.6% without, P Conclusion Although FJ placement during PD is considered to be routine at many institutions, our analysis of data from NSQIP suggest that FJ placement may be associated with increased postoperative morbidity.
H. J. Espiner - One of the best experts on this subject based on the ideXlab platform.
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Alaparoscopic technique forfull thickness intestinal biopsy andfeeding Jejunostomy
1993Co-Authors: W. K. Eltringham, S W Galloway, H. J. Espiner, Surgery KeltringhamAbstract:Alaparoscopic technique isdescribed, suitable forbothfull thickness intestinal biopsy and placement ofafeeding Jejunostomy Tube. Its application inthree casesisreported. The methodissimple, permits full laparoscopic examination oftheabdominal contents and beingminimaliy invasive, facilitates early patient recovery. (Gut1993; 34:122-124)
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A laparoscopic technique for full thickness intestinal biopsy and feeding Jejunostomy.
Gut, 1993Co-Authors: W. K. Eltringham, S W Galloway, A. M. Roe, R A Mountford, H. J. EspinerAbstract:A laparoscopic technique is described, suitable for both full thickness intestinal biopsy and placement of a feeding Jejunostomy Tube. Its application in three cases is reported. The method is simple, permits full laparoscopic examination of the abdominal contents and being minimally invasive, facilitates early patients recovery.