Bowel obstruction associated with a feeding jejunostomy and its association to weight loss after thoracoscopic esophagectomy

Abstract

BackgroundOur aim was to clarify the incidence of bowel obstruction associated with a feeding jejunostomy (BOFJ) after thoracoscopic esophagectomy and its association to characteristics and postoperative change in body weight.MethodsWe reviewed 100 consecutive patients who underwent thoracoscopic esophagectomy with gastric tube reconstruction and placement of a jejunostomy feeding catheter for esophageal cancer. The incidence of BOFJ was evaluated and the change in body weight after surgery was compared between patients with and without BOFJ.ResultsBOFJ developed in 17 patients. Compared to patients without BOFJ, those with BOFJ had a higher preoperative body mass index (23.3\u2009kg/m2 versus 20.9\u2009kg/m2, P\u2009=\u20090.022), and greater postoperative body weight loss rate: 3\u2009month, decrease to 84.2% of initial body weight versus 89.3% (P\u2009=\u20090.002). Patients with BOFJ had shorter distance between the jejunostomy and midline (40\u2009mm versus 48\u2009mm, P\u2009=\u20090.011) compared to patients without BOFJ. On multivariate analysis, higher preoperative body mass index (odds ratio (OR)\u2009=\u20099.248; 95% confidence interval (CI)\u2009=\u20091.344–63.609; p\u2009=\u20090.024), higher postoperative weight loss at 3\u2009months (OR\u2009=\u20098.490; 95% CI\u2009=\u20091.765–40.837, p\u2009=\u20090.008), and shorter distance between the jejunostomy and midline (OR\u2009=\u20098.160; 95% CI\u2009=\u20091.675–39.747, p\u2009=\u20090.009) were independently associated with BOFJ.ConclusionPatients of BOFJ had greater preoperative body mass, shorter distance between jejunostomy and midline, and greater postoperative weight loss.