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ニワ ユキコ
Yukiko Niwa
丹羽 由紀子 所属 医学部 医学科（附属八千代医療センター） 職種 講師 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Feeding duodenostomy decreases the incidence of mechanical obstruction after radical esophageal cancer surgery. |
| 掲載誌名 | 正式名：World journal of surgery 略 称：World J Surg ISSNコード：14322323/03642313 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 39(5),pp.1105-10 |
| 著者・共著者 | Oya Hisaharu, Koike Masahiko, Iwata Naoki, Kobayashi Daisuke, Torii Koji, Niwa Yukiko, Kanda Mitsuro, Tanaka Chie, Yamada Suguru, Fujii Tsutomu, Nakayama Goro, Sugimoto Hiroyuki, Nomoto Shuji, Fujiwara Michitaka, Kodera Yasuhiro |
| 発行年月 | 2015/05 |
| 概要 | BACKGROUND:Nutritional support influences the outcome of gastroenterological surgery, and enteral nutrition effectively mitigates postoperative complications in highly invasive surgery such as resection of esophageal cancer. However, feeding via jejunostomy can cause complications including mechanical obstruction, which could be life threatening. From 2009, we began enteral feeding via duodenostomy to reduce the likelihood of complications. In this study, we compared duodenostomy with the conventional jejunostomy feeding, mainly looking at the catheter-related complications.METHODS:The database records of 378 patients with esophageal cancer who underwent radical esophagectomy with retrosternal or posterior mediastinal gastric tube reconstruction in our department from January 1998 to December 2012 were examined. Of the 378 patients, 111 underwent feeding via duodenostomy (FD) and 267 underwent feeding via jejunostomy (FJ), and their records were reviewed for the following catheter-related complications: site infection, dislodgement, peritonitis, and mechanical obstruction.RESULTS:Mechanical obstruction occurred in 12 patients in the FJ group but none in the FD group (4.5 % vs. 0 %, P = 0.023). Of the 12 cases, 7 (58.3 %) required surgery of which 2 had bowel resection due to strangulated mechanical obstruction. Catheter site infection was seen in 14 cases in the FJ group, of which 2 (14.2 %) had peritonitis following catheter dislocation, while only one case of site infection was seen in the FD group (5.2 % vs. 0.9 %, P = 0.078).CONCLUSIONS:Feeding via duodenectomy could be the procedure of choice since neither mechanical obstruction nor relaparotomy was seen during enteral feeding through this technique. |
| DOI | 10.1007/s00268-015-2952-5 |
| PMID | 25665669 |