Clinical experience of using a feeding catheter gastrostomy following esophagectomy with gastric tube reconstruction via a posterior mediastinal route

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  • 食道切除後縦隔胃管再建時の経胃管経腸栄養カテーテル留置法の臨床成績
  • 臨床経験 食道切除後縦隔胃管再建時の経胃管経腸栄養カテーテル留置法の臨床成績
  • リンショウ ケイケン ショクドウ セツジョ ゴ ジュウカク イカン サイケンジ ノ ケイ イカンケイ チョウ エイヨウ カテーテル リュウチホウ ノ リンショウ セイセキ

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Abstract

Enteral nutrition (EN) is an important strategy for maintaining gut integrity and function. Catheter jejunostomy is popularly used after esophageal resection with gastric tube reconstruction via a posterior mediastinal route. However, jejunal fixation to the peritoneum can potentially cause jejunal obstruction. The purpose of this study was to evaluate our original technique of placing a feeding catheter gastrostomy (FCG) during esophagectomy with gastric tube reconstruction via a posterior mediastinal route. Between November 2009 and July 2011, 30 patients underwent FCG. The catheter was guided to the anterior abdominal wall along the diaphragm via an extra-peritoneal route ; the catheter entry was overlapped by omentum. The median duration of using the indwelling feeding catheter was 31.5 (6-211) days. EN was interrupted in 3 cases : 2 cases with chylothorax and one case with catheter blockage. There were no cases of spontaneous catheter prolapse or bowel obstruction. Only one patient (3.3%) showed mild and transient localized peritonitis after catheter removal. FCG is a safe technique and is useful for avoiding jejunostomy-related bowel obstruction in cases requiring EN following esophageal resection with gastric tube reconstruction via a posterior mediastinal route.

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