Published in:
01-05-2016 | 2015 SSAT Plenary Presentation
Clinical Burden of Laparoscopic Feeding Jejunostomy Tubes
Authors:
Emily A. Speer, Simon C. Chow, Christy M. Dunst, Amber L. Shada, Valerie Halpin, Kevin M. Reavis, Maria Cassera, Lee L. Swanström
Published in:
Journal of Gastrointestinal Surgery
|
Issue 5/2016
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Abstract
Introduction
Feeding jejunostomies (J tubes) provide enteral nutrition when oral and gastric routes are not options. Despite their prevalence, there is a paucity of literature regarding their efficacy and clinical burden.
Methods
All laparoscopic J tubes placed over a 5-year period were retrospectively reviewed. Clinical burden was measured by number of clinical contact events (tube-related clinic visits, phone calls, ED visits) and morbidity (dislodgement, clogging, tube fracture, infection, other). Tube replacements were also recorded.
Results
One hundred fifty-one patients were included. Fifty-nine percent had associated malignancy, and 35 % were placed for nutritional prophylaxis. Mean time to J tube removal was 146 days. J tubes were expected to be temporary in >90 % but only 50 % had sufficient oral intake for removal. Tubes were removed prematurely due to patient intolerance in 8 %. Mortality was 0 %. Morbidity was 51 % and included clogging (12 %), tube fracture (16 %), dislodgement (25 %), infection (18 %) and “other” (leaking, erosion, etc.) in 17 %. The median number of adverse events per J tube was 2(0–8). Mean number of clinic phone calls was 2.5(0–22), ED visits 0.5(0–7), and clinic visits 1.4(0–13), with 82 % requiring more than one J tube-related clinic visit. Unplanned replacements occurred in 40 %.
Conclusion
While necessary for some patients, J tubes are associated with high clinical burden.