SURGICALLY PLACED GASTROJEJUNOSTOMY TUBES HAVE FEWER COMPLICATIONS COMPARED TO FEEDING JEJUNOSTOMY TUBES

Objective: During laparotomy, jejunostomy tubes (J tubes) are often pl aced to provide access for enteral nutrition in the immediate postoper ative period. However, the placement of such tubes may be associated w ith potentially devastating intra-abdominal complications possibly rel ated to the tenuous security of a tube through the small bowel wall. A n alternative method for enteral nutrition access is to surgically pla ce a ''PEG-J'' tube (i.e., surgical G/J tube) thus providing for jejun al feedings via a gastrotomy without a jejunotomy. The purpose of this study is to assess whether surgically placed G/J tubes reduce the pos toperative complications in comparison to feeding J tubes. Methods: Ov er the past 18 months, 92 J tubes and 56 G/J tubes were placed during laparotomy at a single institution and the method chosen by surgeons' preference. The frequency of complications associated with each tube w as determined by review of the postoperative medical records. Results: There was no enteric leakage in those patient given G/J tubes (p < 0. 05). Furthermore 10% of the patients receiving J tubes required operat ive repair of a J tube complication while no patient with an access co mplication following G/J tube placement required surgical repair (p < 0.05). Conclusions: These results demonstrate that operative positioni ng of a jejunal feeding tube through a gastrostomy tube (surgical G/J tube) provides a safer route for enteral nutrition than does direct tu be placement via the jejunal wall, by significantly reducing both the incidence of enteric leakage and the requirement for operative repair.