Jejunostomy tubes are frequently placed at time of esophagectomy. The purpose of this
study is to evaluate cessation of routine j-tube placement on postoperative body mass
index (BMI), return to the emergency room, and time until adjuvant therapy. We performed
a retrospective review of an institutional database for consecutive patients undergoing
minimally invasive Ivor Lewis Esophagectomy from 2014-2021 (after January 2019, routine
j-tube placement was abandoned). Data was analyzed using Pearson′s Chi-squared tests
and Student's t test with 2-sided significance level of P < 0.05. In total,179 patients were included, 95 underwent j-tube placement and 84 did
not. Cohorts had comparable baseline BMI's (no j-tube: 30.48 vs j-tube: 28.64, P = 0.06) and anastomotic leak rates (2.4% vs 4.2%, P = 0.5). Patients with no jejunostomy tubes were more likely to receive total parenteral
nutrition (14.3% vs 5.3%, P < 0.05), but were no more likely to require total parenteral nutrition at discharge
and had comparable durations of TPN requirement (7 days vs 12 days, P = 0.53). There was no difference in mean BMI reduction at 2 weeks (2.54 vs 2.09, P = 0.49) and 3-6 months postoperatively (6.11 vs 4.45 P = 0.15). There was no difference in return to the emergency room (8.3% vs 8.4%, P = 0.98) or readmissions (13.1% vs 11.6%, P = 0.76). There was a no difference in mean time to adjuvant therapy (83.5 days vs 72.6
days, P = 0.67). At esophagectomy centers with low anastomotic leak rates, cessation of routine
j-tube placement at time of minimally esophagectomy can be undertaken without increasing
risk of readmission, time until initiation of adjuvant therapy, or significantly impacting
postoperative BMI loss.
Graphical Abstract
Graphical Abstract
Keywords
Abbreviations:
J-tube (jejunostomy tube), BMI (body mass index), ER (emergency room), ECCG (esophageal complication consensus group), EGD (esophagogastroduodenoscopy), NGT (nasogastric tube), ERAS (enhanced recovery after surgery), POD (postoperative day), NPO (nil per os (nothing by mouth)), TPN (total parenteral nutrition)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 11, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding: None.
Conflicts of Interest: The authors have no conflicts of interest to disclose.
IRB: 18D.281, 9/7/21
Read at the AATS 102nd Annual Meeting, May 14-17, 2022, Boston, MA.
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