Percutaneous replacement jejunostomy after esophagogastrectomy

A surgically placed jejunostomy tube is a safe and effective means of deliv ering nutritional support for the postesoghagogastrectomy patient. We have previously described a method that permits percutaneous replacement of surg ically placed jejunostomy feeding tubes, and now present our results with t he use of this technique in 350 consecutive esophagogastrectomy patients. R eplacement jejunostomy was required in 17 patients (4.9%). All patients had successful percutaneous jejunostomy replacement. There were no procedural complications or deaths. The timing of feeding tube replacement following e sophagogastrectomy was predictive of the indication. Before 16 weeks, the i ndication for feeding tube replacement was intubation and inability to eat (1 patient) or anorexia with weight loss and dehydration (7 patients). At o r after 16 weeks, the indications for feeding tube replacement were all rel ated to symptoms resulting from recurrent carcinoma. We conclude that the t echnique of percutaneous jejunostomy allows the surgeon tremendous flexibil ity in the management of the postesophagogastrectomy patient as it preserve s the advantages of an adjuvant surgically placed feeding tube over the lif etime of the patient. The technique is safe, and the success rate is excell ent.