Comparison of laparoscopy versus mini-laparotomy for jejunostomy placement in patients with gastric adenocarcinoma
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and Other Interventional Techniques
Comparison of laparoscopy versus mini‑laparotomy for jejunostomy placement in patients with gastric adenocarcinoma Catherine H. Davis1 · Naruhiko Ikoma2 · Paul F. Mansfield2 · Prajnan Das3 · Bruce D. Minsky3 · Mariela A. Blum4 · Jaffer A. Ajani4 · Barbara L. Bass1 · Brian D. Badgwell2 Received: 30 May 2020 / Accepted: 4 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Optimal nutrition is challenging for patients with gastric and gastroesophageal adenocarcinoma and often requires feeding tube placement prior to preoperative therapy. Feeding jejunostomy (FJ) placement via mini-laparotomy is technically easier to perform than laparoscopic FJ. The purpose of this study was to compare outcomes in patients with gastric adenocarcinoma undergoing laparoscopic versus mini-laparotomy FJ placement. Methods A retrospective cohort study was performed of patients with gastric adenocarcinoma receiving laparoscopic versus mini-laparotomy FJ at a single tertiary referral center from 2000 to 2018. 30-day outcomes included complications, conversion to laparotomy, reoperation, length of stay, and readmission. Results A total of 656 patients met the inclusion criteria and were studied. The majority of patients were male (68.1%) with a mean age of 60.6 years. The difference in surgical approach remained relatively stable over time. Overall, 82 (12.5%) patients experienced complications, and three (0.5%) patients died postoperatively. While readmission and conversion to open laparotomy did not differ between groups, overall complications (10.5% vs. 20.8%, p = 0.002), Clavien–Dindo ≥ 3 complications (4.0% vs. 8.9%, p = 0.021), length of stay (4.1 vs. 5.6 days, p
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