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Volume 13 Issue 5
Sep.  2022
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Article Navigation >  Medical Journal of Peking Union Medical College Hospital  > 2022  >  13(5): 845-851
ZHAO Luo, HE Jia, QIN Yingzhi, HAN Zhijun, LIU Hongsheng, LI Shanqing, LI Li. Application of Laparoscopic Jejunostomy in Minimal Invasive McKeown Esophagectomy[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(5): 845-851. doi: 10.12290/xhyxzz.2021-0635
Citation: ZHAO Luo, HE Jia, QIN Yingzhi, HAN Zhijun, LIU Hongsheng, LI Shanqing, LI Li. Application of Laparoscopic Jejunostomy in Minimal Invasive McKeown Esophagectomy[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(5): 845-851. doi: 10.12290/xhyxzz.2021-0635
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Application of Laparoscopic Jejunostomy in Minimal Invasive McKeown Esophagectomy

doi: 10.12290/xhyxzz.2021-0635

  • Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funds:

National High Level Hospital Clinical Research Funding 2022-PUMCH-A-258

More Information
  • Corresponding author: LI Li, E-mail: lili4037@pumch.cn
  • Received Date: 2021-09-05
  • Accepted Date: 2021-10-20
  • Publish Date: 2022-09-30
    Abstract
  •   Objective  To evaluate the safety and clinical value of laparoscopic jejunostomy in minimal invasive McKeown esophagectomy.  Methods  The clinical data of the patients undergoing minimally invasive McKeown esophagectomy in the Department of Thoracic Surgery, Peking Union Medical College Hospital from January 2013 to June 2020 were retrospectively included, and according to postoperative nutritional support they were divided into oral intake group (January 2013 to October 2017) and jejunostomy group (November 2017 to June 2020). The operation time, postoperative hospital stay, complications, perioperative nutritional status and quality of life scores were compared between the two groups.  Results  A total of 190 patients with esophageal cancer who met the inclusion and exclusion criteria were enrolled. There were 128 cases in jejunostomy group and 62 cases in oral intake group. Compared with the patients in oral intake group, those in jejunostomy group had shorter postoperative hospitalization time [11(9, 13)d vs. 14(13, 20)d, P < 0.001], the completion rate of postoperative adjuvant chemotherapy in the jejunostomy group was higher(95.16% vs. 75.00%, P=0.005). The operation time [335(300, 374)min vs. 330(310, 370)min, P=0.750] and the incidence of surgery-related complications(28.13% vs. 35.48%, P=0.748) showed no significant difference between the two groups. The body mass index in jejunostomy group was higher 1 month [(23.3 ± 3.5)kg/m2 vs. (21.7±3.9)kg/m2, P=0.006] and 3 months[(22.6±3.5)kg/m2 vs. (20.6±4.0)kg/m2, P < 0.001] after surgery, and the body weight decreasing rate was lower 1 month [(3.9 ± 2.2)% vs. (10.3±3.5)%, P < 0.001] and 3 months[(6.5±3.1)% vs. (15.7 ± 4.8)%, P < 0.001] after surgery than those in oral intake group. The quality of life symptom scores in both groups were increased and the physical functioning and summary scores were sharply decreased at day 7 after operation, and all scores were improved in different degrees 1 month after operation. Compared with the measurements in oral intake group, the symptom scores (except pain score 1 month after operation) were decreased, and the physical functioning and summary scores were increased in the jejunostomy group 7 days and 1 month after operation (all P < 0.05).  Conclusion  Compared with oral nutrition, total laparoscopic jejunostomy has greater advantages in postoperative nutritional support and quality of life recovery in patients with esophageal cancer. It is also safe and unlikely to increase surgery-related complications.
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    • References(13)
  • [1] Smeets BJJ, Luyer MDP. Nutritional interventions to improve recovery from postoperative ileus[J]. Curr Opin Clin Nutr Metab Care, 2018, 21: 394-398. doi:  10.1097/MCO.0000000000000494
    [2] Siow SL, Mahendran HA, Wong CM, et al. Laparoscopic T-tube feeding jejunostomy as an adjunct to staging laparoscopy for upper gastrointestinal malignancies: the technique and review of outcomes[J]. BMC Surg, 2017, 17: 25. doi:  10.1186/s12893-017-0221-2
    [3] Zhang Y, Duan R, Xiao X, et al. Minimally invasive esophagectomy with right bronchial occlusion under artificial pneumothorax[J]. Dig Surg, 2015, 32: 77-81. doi:  10.1159/000371747
    [4] Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology[J]. J Natl Cancer Inst, 1993, 85: 365-376. doi:  10.1093/jnci/85.5.365
    [5] Findlay JM, Gillies RS, Millo J, et al. Enhanced recovery for esophagectomy: a systematic review and evidence-based guidelines[J]. Ann Surg, 2014, 259: 413-431. doi:  10.1097/SLA.0000000000000349
    [6] Berkelmans GH, van Workum F, Weijs TJ, et al. The feeding route after esophagectomy: a review of literature[J]. J Thorac Dis, 2017, 9: S785-S791. doi:  10.21037/jtd.2017.03.152
    [7] Fujita T, Daiko H, Nishimura M. Early enteral nutrition reduces the rate of life-threatening complications after thoracic esophagectomy in patients with esophageal cancer[J]. Eur Surg Res, 2012, 48: 79-84. doi:  10.1159/000336574
    [8] Akiyama Y, Iwaya T, Endo F, et al. Evaluation of the need for routine feeding jejunostomy for enteral nutrition after esophagectomy[J]. J Thorac Dis, 2018, 10: 6854-6862. doi:  10.21037/jtd.2018.11.97
    [9] Tao Z, Zhang Y, Zhu S, et al. A Prospective Randomized Trial Comparing Jejunostomy and Nasogastric Feeding in Minimally Invasive McKeown Esophagectomy[J]. J Gastrointest Surg, 2020, 24: 2187-2196. doi:  10.1007/s11605-019-04390-y
    [10] Derogar M, Orsini N, Sadr-Azodi O, et al. Influence of major postoperative complications on health-related quality of life among long-term survivors of esophageal cancer surgery[J]. J Clin Oncol, 2012, 30: 1615-1619. doi:  10.1200/JCO.2011.40.3568
    [11] Toh Y, Morita M, Yamamoto M, et al. Health-related quality of life after esophagectomy in patients with esophageal cancer[J]. Esophagus, 2022, 19: 47-56. doi:  10.1007/s10388-021-00874-6
    [12] Koterazawa Y, Oshikiri T, Hasegawa H, et al. Routine placement of feeding jejunostomy tube during esophagectomy increases postoperative complications and does not improve postoperative malnutrition[J]. Dis Esophagus, 2020, 33: doz021. doi:  10.1093/dote/doaa021
    [13] Berkelmans GHK, Kingma BF, Fransen LFC, et al. Feeding protocol deviation after esophagectomy: A retrospective multicenter study[J]. Clin Nutr, 2020, 39: 1258-1263. doi:  10.1016/j.clnu.2019.05.018
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