TRANSVERSE WITZEL-T-TUBE FEEDING JEJUNOSTOMY

Background: In patients prone to recurrent aspiration, a feeding jejun ostomy is only performed to ensure adequate nutrition. A popular metho d for placement of the jejunostomy tube is the Witzel procedure, emplo ying a sersosal tunnel on the antimesenteric border. The Witzel proced ure, however, frequently suffers from the complication of tube dislodg ement and obstruction due to narrowing of the intestinal lumen. Method s: To minimize the complications associated with the standard Witzel m ethod, we modified the procedure wherein a T-tube is substituted for a standard French rubber catheter, and transversely sutured to the mese nteric border. We believe that the placement of the Witzel line in the transverse plane minimizes the risk of obstruction, and substitution of a T-tube for a standard French catheter should reduce the incidence of tube dislodgement. Results: The Transverse Witzel T-tube feeding j ejunostomy has been performed successfully in 30 patients without any complications of tube dislodgement or leaks, and no tube to date has b een difficult to remove. Length of tube use has ranged from I to 6 mon ths, and no postoperative complications have been observed in this gro up. Conclusions: The Transverse Witzel T-tube jejunostomy is an effect ive and rapid technique for placement of a feeding tube. No serious co mplications have been observed, and the complication of tube dislodgem ent appears to be decreased compared to the standard Witzel procedure.