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

Application of Laparoscopic Jejunostomy in Minimal Invasive McKeown Esophagectomy

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: September 04, 2021
  • Accepted Date: October 19, 2021
  • Issue Publish Date: September 29, 2022
  •   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.
  • [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
  • Related Articles

    [1]ZHANG Ning, YANG Chenhao, ZHOU Liangrui, SUN Xiaohong, LIU Xiaohong, KANG Lin, LI Ji, LI Hailong. Cronkhite-Canada Syndrome Combined with Asymptomatic Novel Coronavirus Infection: A Case Report[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(2): 406-412. DOI: 10.12290/xhyxzz.2023-0476
    [2]ZHANG Lu, LI Jian. Castleman Disease in China: State-of-the-art Technology Before the Era of IL-6 Targeted Therapy[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(5): 911-914. DOI: 10.12290/xhyxzz.2023-0227
    [3]LUO Jichang, WANG Tao, JIAO Liqun. Treatment of Intracranial Atherosclerotic Stenosis: Current Debates and Future Directions[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(6): 907-914. DOI: 10.12290/xhyxzz.2022-0592
    [4]Rare Diseases Society of Chinese Research Hospital Association, National Rare Diseases Committee, Beijing Rare Disease Diagnosis, Treatment and Protection Society, Gitelman Syndrome Consensus Working Group. Expert Consensus for the Diagnosis and Treatment of Gitelman Syndrome in China (2021)[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(6): 902-912. DOI: 10.12290/xhyxzz.2021-0555
    [5]Xiao-bo ZHANG, Zheng-yu JIN. Does Acute Cerebral Venous Sinus Thrombosis Require Endovascular Treatment?[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(2): 140-143. DOI: 10.3969/j.issn.1674-9081.20190271
    [6]Ming-sheng MA, Xü-de ZHANG, Min WEI, Shi-min ZHAO, Zheng-qing QIU. Efficacy of Low Dose Corticosteroid Therapy in Duchenne Muscular Dystrophy[J]. Medical Journal of Peking Union Medical College Hospital, 2014, 5(4): 384-388. DOI: 10.3969/j.issn.1674-9081.2014.04.006
    [7]Ying ZHANG, Jin-song GAO, Jun-tao LIU, Hai-yuan LIU, Ying-na SONG, Xiao-ming GONG, Zhi-jing SUN. Effectiveness of B-lynch Suture in Treatment and Prevention of Postpartum Hemorrhage[J]. Medical Journal of Peking Union Medical College Hospital, 2013, 4(2): 174-177. DOI: 10.3969/j.issn.1674-9081.2013.02.019
    [8]Jie LIU, Yue-ping ZENG, Chun-xia HE, Qin LONG, Hong-zhong JIN, Qiu-ning SUN. Corticosteroids plus Intravenous Immunoglobulin in the Treatment of 7 Cases with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(4): 381-385. DOI: 10.3969/j.issn.1674-9081.2012.04.004
    [9]Shuai TANG, Jie YI, Yu-guang HUANG. Cardiovascular Responses of Intubation with Shikani Seeing Optical Stylet and Macintosh Laryngoscope[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(3): 314-317. DOI: 10.3969/j.issn.1674-9081.2012.03.015
    [10]Xiao-hua SHI, Zhi-yong LIANG, Huan-wen WU, Xin-yu REN, Tong-hua LIU. Effect of RNA Interference Plasmid on the Expression of Oncogene AKT2 in Pancreatic Cancer Cell Line Panc-1[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(1): 102-108. DOI: 10.3969/j.issn.1674-9081.2012.01.021
  • Cited by

    Periodical cited type(3)

    1. 仇芳娟,郭小靖,彭会琴. 大颗粒绷带包扎联合瑜伽操方案在乳腺癌术后患者中的应用. 当代护士(中旬刊). 2025(01): 88-91 .
    2. 李叶玭,董菲妮,洪志鹏. 改良绷带加压包扎法结合针对性护理对乳腺癌术后上肢淋巴水肿的影响. 中国卫生标准管理. 2024(15): 170-174 .
    3. 吕子岩,蓝敏. 乳腺癌相关淋巴水肿的康复治疗. 加速康复外科杂志. 2024(02): 86-90 .

    Other cited types(0)

Catalog

    Article Metrics

    Article views (360) PDF downloads (38) Cited by(3)
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return
    x Close Forever Close