1. Bowel obstruction associated with a feeding jejunostomy and its association to weight loss after thoracoscopic esophagectomy
- Author
-
Hiroyuki Kitagawa, Jun Iwabu, Sunao Uemura, Masaya Munekage, Keiichiro Yokota, Michiya Kobayashi, Kazuhiro Hanazaki, and Tsutomu Namikawa
- Subjects
Male ,Esophageal Neoplasms ,medicine.medical_treatment ,Esophageal cancer ,Jejunostomy ,Body Mass Index ,0302 clinical medicine ,Weight loss ,Risk Factors ,Postoperative Period ,Aged, 80 and over ,Gastroenterology ,General Medicine ,Middle Aged ,Bowel obstruction ,Catheter ,030220 oncology & carcinogenesis ,Preoperative Period ,030211 gastroenterology & hepatology ,Female ,medicine.symptom ,Research Article ,Adult ,medicine.medical_specialty ,Thoracoscopic esophagectomy ,Feeding jejunostomy ,Body weight loss ,03 medical and health sciences ,Enteral Nutrition ,Weight Loss ,medicine ,Humans ,lcsh:RC799-869 ,Aged ,Retrospective Studies ,business.industry ,Thoracoscopy ,Odds ratio ,Jejunal Diseases ,medicine.disease ,Confidence interval ,Surgery ,Esophagectomy ,Bowel obstruction associated with a feeding jejunostomy ,lcsh:Diseases of the digestive system. Gastroenterology ,business ,Body mass index ,Intestinal Obstruction - Abstract
Background Our aim was to clarify the incidence of bowel obstruction associated with a feeding jejunostomy (BOFJ) after thoracoscopic esophagectomy and its association to characteristics and postoperative change in body weight. Methods We reviewed 100 consecutive patients who underwent thoracoscopic esophagectomy with gastric tube reconstruction and placement of a jejunostomy feeding catheter for esophageal cancer. The incidence of BOFJ was evaluated and the change in body weight after surgery was compared between patients with and without BOFJ. Results BOFJ developed in 17 patients. Compared to patients without BOFJ, those with BOFJ had a higher preoperative body mass index (23.3 kg/m2 versus 20.9 kg/m2, P = 0.022), and greater postoperative body weight loss rate: 3 month, decrease to 84.2% of initial body weight versus 89.3% (P = 0.002). Patients with BOFJ had shorter distance between the jejunostomy and midline (40 mm versus 48 mm, P = 0.011) compared to patients without BOFJ. On multivariate analysis, higher preoperative body mass index (odds ratio (OR) = 9.248; 95% confidence interval (CI) = 1.344–63.609; p = 0.024), higher postoperative weight loss at 3 months (OR = 8.490; 95% CI = 1.765–40.837, p = 0.008), and shorter distance between the jejunostomy and midline (OR = 8.160; 95% CI = 1.675–39.747, p = 0.009) were independently associated with BOFJ. Conclusion Patients of BOFJ had greater preoperative body mass, shorter distance between jejunostomy and midline, and greater postoperative weight loss.
- Published
- 2019