ASPIRATION PNEUMONIA FOLLOWING SURGICALLY PLACED FEEDING TUBES

BACKGROUND: The enteral route is preferred in surgical patients requir ing nutritional support; however, controversy surrounds the choice of location of feeding tube placement. Although jejunostomy has been comm only accepted as superior to gastrostomy for long-term nutritional sup port because of an assumed lower risk of aspiration pneumonia, recent studies suggest that reevaluation of common practices of surgical tube placement is warranted. PATIENTS AND METHODS: We conducted a retrospe ctive chart review of gastrostomy and jejunostomy procedures from 1986 to 1993. Demographic information and complications related to the pro cedure were reviewed. Aspiration pneumonia was defined as respiratory symptoms, leukocytosis, and infiltrate on chest radiograph. RESULTS: S ixty-nine gastrostomies and 86 jejunostomies were performed during the study period. Six patients were diagnosed with aspiration pneumonia; 2 cases of which occurred with jejunostomy and 4 cases occurred with g astrostomy (P = not significant). CONCLUSIONS: There was no difference in rates of pulmonary aspiration or other complications between gastr ostomy and jejunostomy. We suggest that when a surgically placed feedi ng tube is required, the determination of appropriate procedure be bas ed on clinical factors such as the technical difficulty of the operati on or long-term feeding goals.