SUBCUTANEOUSLY IMPLANTED ENTERAL NUTRITION PORT

Background: Patients who have undergone esophagectomy with extensive l ymph node dissection under thoracolapalotomy for advanced esophageal c arcinomas frequently need long-term nutrition support because of their inadequate oral intake. We have used tube enterostomy feeding for the se patients not only immediately after the operations but also at home to prevent the development of malnutrition. Patients who receive long -term tube enterostomy feeding often suffer from skin problems around the enteral nutrition catheters. Once the catheter is removed, the pat ient with anticipated malnutrition is subsequently unable to receive b eneficial enteral nutrition. We have developed a new enteral access sy stem that is placed subcutaneously This subcutaneously implanted enter al nutrition port makes possible intermittent and long-term enteral nu trition support not only for the postoperative period but also for hom e care. Methods: This system consists of the port (Infuse-a-Port, SMAP 15 Snaplock Macro-Port Venous Access System; Strato Medical Co) and th e enteral nutrition tube (Enteral Tube 8F, 75 cm; Zeon Co). This syste m was applied to seven patients who had undergone esophagectomy. The p ort was placed on the lower chest subcutaneously, and the catheter was placed through the gastric tube and duodenum up to the jejunum. After the operation, a 20-gauge port needle was placed, and enteral nutriti on formula (Enterued; Termo Co) was started with the enteral nutrition pump. Results: No complications (eg, infection of skin, obstruction o f tube) were observed from the postoperative period through the home c are stage. The observation period for this implanted system ranged fro m 2 to 12 months. The patients were able to avoid the malnutrition ant icipated after the extensive operations and continued to receive nutri tion support safely and effectively at home. Conclusion: This new nutr ition support system is safe and efficient for patients who anticipate long-term enteral nutrition support. A subcutaneously implanted enter al nutrition port makes possible intermittent and long-term nutrition support without patient discomfort and inconvenience.