Table 2.
Comparison of selected studies on laparoscopic feeding jejunostomy in cohorts of 10 or more patients
| Author | No.of Cases | Indication for placement | Operative Techniques (total laparoscopic/laparoscopic aided) | Tube-related complications (Minor/Major) | Feed-related gastrointestinal symptoms | Conclusions |
|---|---|---|---|---|---|---|
| Sangster W et al. [9] | 23 | Various indications | Total laparoscopic using a 10-French jejunostomy catheter kit | Minor complications (n = 2, 8.7%): superficial skin breakdown around the tube (n = 2). Major complications (n = 1, 4.3%): superficial abscess around the tube requiring I & D. One unrelated death. | NM | No procedure related complications. A valuable addition to the surgeon’s options for obtaining enteral access. |
| Grondona P et al. [10] | 18 | Part of staging laparoscopy for esophagogastric cancer | Total laparoscopic using a dedicated feeding jejunostomy kit | Minor complications (n = 3, 16.7%): tube dislodged (n = 1), leakage with wound infection (n = 1) & wound infection (n = 1). No major complications. | NM | A safe and reliable technique. A useful adjunct to staging laparoscopy for esophagogastric cancer. |
| Allen JW et al. [15] | 35 | Various indications | Total laparoscopic using a 16 French T-tube | Minor complications (n = 4, 11.4%): wound infection (n = 2) & leakage (n = 2) Major complications (n = 1, 2.9%): intractable pain requiring laparotomy | NM | Safe technique with no significant morbidity or mortality |
| Ben-David K et al. [21] | 153 | Prior to definitive minimally invasive esophagectomy | Total laparoscopic using a 16-French T-tube | Minor complications (n = 15, 9.8%): superficial wound infection (n = 4), dislodgement (n = 2), leak (n = 4) & clogging (n = 5). No major complications. | NM | A feasible and safe technique in one of the largest series of laparoscopic feeding jejunostomy tube for esophageal cancer patients. |
| Mistry RC et al. [20] | 19 | Oesophageal resection | Total laparoscopic using a 12-French T-tube | Minor complications (n = 1, 5.3%): extraperitoneal leakage of feeds due to a damaged vertical limb of the T-tube. | NM | An easy, inexpensive technique that does not require specialized equipment or feeding tubes. |
| Senkal M et al. [12] | 80 | Primary or recurrent tumors of the upper gastrointestinal tract | Total laparoscopic using a 9-French jejunostomy catheter kit | Minor complications (n = 7, 8.8%): leakage (n = 2), tube occlusion (n = 3) & dislodgement (n = 2). Major complications (n = 1, 1.3%): abscess at the insertion site requiring drainage. | NM | A safe and effective technique. Does not require special equipment such as T-fasteners, or transabdominal suturing. |
| Heath EI et al. [1] | 59 | Part of the staging laparoscopy for esophageal cancer | Total laparoscopic using a 10-French jejunostomy tube | Only major complications reported (n = 2, 3.4%): perforation of the small bowel requiring laparotomy and small bowel resection (n = 1) & intraoperative pulmonary oedema secondary to aortic valve stenosis (n = 1). | NM | Reported only two major complications with only one related to the procedure of laparoscopic feeding jejunostomy. Minor complications were not reported. |
| Hotokezaka M et al. [11] | 32 | Various indications | Total laparoscopic using an 18-French Silastic duallumen feeding tube | Conversion to open (n = 4, 12.5%). Minor complications (n = 9, 32.1%): dislodgement (n = 3), obstruction (n = 2) & leakage/wound erythema (n = 4). Major complications (n = 3, 10.7%): dislodgement (n = 1) & aspiration pneumonia (n = 2). Death within 30 days (n = 3, 10.7%): aspiration pneumonia and respiratory distress (n = 1) & unrelated death (n = 2). | Four patients (14.2%) had nausea and one (3.6%) abdominal cramp. | Safe procedure. High morbidity is usually related to preexisting disease. Previous abdominal surgery is not necessarily a contraindication. |
| Jenkinson AD et al. [17] | 43 | Part of the laparoscopic staging for esophagogastric cancer | Total laparoscopic using a 6-French infant feeding catheter (Vygon) | Minor complications (n = 11, 25.6%): dislodgement (n = 5), blockage (n = 4) & connector breakage (n = 2). Major complications (n = 1, 2.3%): Dislodgement requiring laparoscopic replacement. | NM | A safe and simple technique that adds little to the morbidity and cost of managing patients with esophagogastric cancers. |
| Pili D, et al. [30] | 25 | Patients undergoing major surgery for esophageal cancer | Total laparoscopic using 8- French jejunostomy catheter kit. | Minor complications (n = 3, 12.0%): chronic catheter occlusion (n = 2) & slippage (n = 1). No major complications. | NM | No procedure related morbidity or mortality. A feasible procedure with the use of autoadjustable sutures to overcome the limitation of the laparoscopic handling. |
| Duh QY et al. [5] | 36 | Various indications (a multicentre study) | Total laparoscopic using jejunostomy catheter kit and T-fasteners. | Conversion to open (n = 3, 8%). Minor complications (n = 6, 16.7%): wound erythema or infection (n = 3) & dislodgement (n = 3). Major complications (n = 3, 8.3%): volvulus (n = 1) & dislodgement (n = 2). Death (n = 4, 11.1%): unrelated to procedure. | NM | A safe and effective technique when done by experienced laparoscopic surgeons. Serious complications are rare. |
| Young MT et al. [13] | 299 | Various indications with majority for esophagogastric cancer | Total laparoscopic using 10-French jejunostomy catheter kit | No conversion to open surgery. aEarly complications (n = 12, 4.0%): dislodgement (n = 3), clogging (n = 3), intraperitoneal displacement (n = 2), broken tube (n = 1), rectus sheath hematoma (n = 1) & abdominal wall site infection (n = 2). Late complications (n = 26, 8.7%): small bowel obstruction (n = 1), jejunal fistula (n = 11), dislodgement (n = 10) & broken or cogged tube (n = 4). Mortality (n = 1, 0.3%): unrelated to procedure. | NM | A safe and feasible technique. Associated with a low rate of small bowel obstruction and no intraabdominal catheter-related infection. |
| Present series | 15 | Part of the staging laparoscopy for upper gastrointestinal malignancies | Total laparoscopic using 18-French T-tube | Minor complications (n = 7, 46.7%): Skin excoriation around tubing (n = 4) & catheter dislodgement (n = 3). No major complications. | Three patients (20.0%) had feed intolerance. | A safe, cost-effective technique with no procedure related complications. |
I & D incision & drainage, NM not mentioned. aThe authors divided the complications into early (30-day) and late (˃30 day), and did not fully specify the treatment action for each individual complications and hence not able to differentiate between minor and major complications