COMPARISON OF SHORT TERM COMPLICATIONS BETWEEN OPEN AND LAPAROSCOPIC JEJUNOSTOMY
YIYING LEE*1, Chih-Cheng Hsieh1, Hong-Che Chien2
1VGHTPE, Taipei, Taiwan; 2National Yang-Ming University Hospital, Yilan, Taiwan
Purpose：
The favorable effects of early enteral feeding have been established. Providing nutritional support for patients is important, especially for those who are unable to eat adequately via mouth for diverse medical circumstances. Jejunostomy catheters for feeding is an effective method to improve the nutrition status in these patients. But, there are two major approaches methods. The aim of this study is to compare the short-term complications of patients who underwent feeding jejunostomy between open and laparoscopic approaches.
Materials and Methods：
A retrospective review was performed for patients who underwent first time laparoscopic or open jejunostomy in Taipei Veterans General Hospital from Aug. 2013 to May. 2018. The procedure-related complications were grouped by the Clavien-Dindo classification and compared between the laparoscopic and open methods from operative date to 90 days after operation.
Results：
Total 215 patients underwent laparoscopic procedure and 122 underwent open jejunostomy. The laparoscopic jejunotomy had early enteral feeding, compared with open jejunostomy (2.2 vs 3.2 days, p=0.001). The overall complication rate was 53.4% (180/337), including tube dislodgement, tube obstruction, granulation tissue formation, wound infection and so on. The complication rate of open group was significantly higher than laparoscopic group, including dislodgement (19.6% vs 8.3%, p=0.003), obstruction (25.4% vs 10.6%, p=0.001) and granulation tissue formation (61.4% vs 11.6%, p=0.001).
Conclusion：
Feeding jejunostomy tube-related complications are common. The need for patients with feeding jejunostomy should be carefully evaluated the benefits and the complications of tube insertion and usage. We confirmed the laparoscopic approach is feasible with early enteral feeding and lower rate of occurance of short-term complications, especially in tube dislodgement, obstruction and granulation tissue formation.
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