Landon Guntman, MD, Adil Ayub, MD, Sadiq Rehmani, MD, Faiz Bhora, MD, FACS, Wissam Raad, MD, FACS. Icahn School of Medicine at Mount Sinai
Background: Placement of a feeding jejunostomy tube (FJ) is often performed during esophagectomy. Few studies, however, have sought to determine whether concomitant placement affects postoperative outcomes of esophagectomy.
Materials and methods: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried using current procedural terminology (CPT) billing codes to identify all patients who underwent elective esophagectomy secondary to cancer between 2012 and 2014. Subgroup analysis was performed to determine whether there was any difference based on neck, chest, or an enteral/colonic transposition anastomosis. Patient demographics, comorbidities, operative characteristics and postoperative complications were compared using Chi-squared and Wilcoxon-Mann-Whitney test.
Results: A total of 3051 cases were identified. FJ placement was concomitantly placed in 1794(59%). Overall, the thirty-day-postoperative mortality did not differ between the two groups (2.6% for patients with FJ versus 2.0% without, P 0.258). The readmission rate, return to OR, LOS, and wound infection rates were similar. The mean operative time was longer in those undergoing concomitant FJ (375 min for patients with FJ versus 335 min without, P 0.0001). Postoperative pneumonia, and UTI were higher in patients undergoing FJ placement during esophagectomy. Upon subgroup analysis, when a cervical anastomosis was performed, the rate of superficial SSI was 6.4% in the FJ group versus 10% in the non-FJ group.
Conclusion: Although FJ placement during esophagectomy is associated with increased operative time, pneumonia, and UTI, our analysis of data from NSQIP suggest that FJ placement is not associated with increased mortality, debilitating postoperative morbidity, readmission, or increased length of stay. When a cervical anastomosis is performed, FJ placement is associated with a lower rate of superficial SSI.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86875
Program Number: P736
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster