Clinical Burden of Laparoscopic Feeding Jejunostomy Tubes

J Gastrointest Surg. 2016 May;20(5):970-5. doi: 10.1007/s11605-016-3094-2. Epub 2016 Feb 19.


Introduction: Feeding jejunostomies (J tubes) provide enteral nutrition when oral and gastric routes are not options. Despite their prevalence, there is a paucity of literature regarding their efficacy and clinical burden.

Methods: All laparoscopic J tubes placed over a 5-year period were retrospectively reviewed. Clinical burden was measured by number of clinical contact events (tube-related clinic visits, phone calls, ED visits) and morbidity (dislodgement, clogging, tube fracture, infection, other). Tube replacements were also recorded.

Results: One hundred fifty-one patients were included. Fifty-nine percent had associated malignancy, and 35 % were placed for nutritional prophylaxis. Mean time to J tube removal was 146 days. J tubes were expected to be temporary in >90 % but only 50 % had sufficient oral intake for removal. Tubes were removed prematurely due to patient intolerance in 8 %. Mortality was 0 %. Morbidity was 51 % and included clogging (12 %), tube fracture (16 %), dislodgement (25 %), infection (18 %) and "other" (leaking, erosion, etc.) in 17 %. The median number of adverse events per J tube was 2(0-8). Mean number of clinic phone calls was 2.5(0-22), ED visits 0.5(0-7), and clinic visits 1.4(0-13), with 82 % requiring more than one J tube-related clinic visit. Unplanned replacements occurred in 40 %.

Conclusion: While necessary for some patients, J tubes are associated with high clinical burden.

Keywords: Burden; Enteral nutrition; Feeding tube; Jejunostomy; Laparoscopic feeding jejunostomy; Laparoscopy.

MeSH terms

  • Enteral Nutrition / adverse effects
  • Enteral Nutrition / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intubation, Gastrointestinal / adverse effects
  • Intubation, Gastrointestinal / instrumentation*
  • Jejunostomy / adverse effects
  • Jejunostomy / instrumentation*
  • Laparoscopy*
  • Male
  • Middle Aged
  • Morbidity / trends
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Treatment Failure
  • United States / epidemiology