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Article
A Two Institution Experience With 226 Endoscopically Placed Jejunal Feeding Tubes in Critically Ill Surgical Patients
The American Journal of Surgery
  • Jeffrey Nicholas
  • Mark W. Cornelius
  • Kathryn M. Tchorz, Wright State University
  • Lorraine N. Tremblay
  • E. Ronald Spiegelman
  • Kirk A. Easley
  • William Small
  • David V. Feliciano
  • Melissa A. Powell
  • Jerry Poklepovic
Document Type
Article
Publication Date
12-1-2003
Abstract
Background Early jejunal feeding after surgery or trauma reduces infectious complications. Although not ideal gastric and postpyloric feedings are often used, however, because of difficulty in placing feeding tubes distal to the ligament of Treitz (LOT). Our hypothesis was that feeding tube placement distal to the LOT can be accomplished using a bedside transendoscopic technique. Methods Transendoscopic jejunal (TEJ) tube placement and TEJ tubes inserted simultaneously through percutaneous gastrostomy (PEG) tubes (PEG/TEJ) were attempted to be placed distal to the LOT. Results In all, 226 feeding tubes (185 TEJ, 41 PEG/TEJ) were placed in 179 trauma and 47 nontrauma patients over 3 years (August 20, 1998 to July 15, 2001). Tube location was jejunal in 93.8% of trauma patients, 76.6% of nontrauma patients, and 90.3% of all patients. (Confidence intervals were 89.3% to 96.5%, 62.8% to 86.4%, and 85.7% to 93.5%). Days of total parenteral nutrition were reduced 71.3% in trauma patients, 22.8% in nontrauma patients, and 45% overall at one institution. Conclusions Bedside TEJ and PEG/TEJ placement is safe and successful in placing feeding tubes distal to the LOT in more than 90% of critically ill surgical patients.
Comments

This paper was presented at the 55th annual meeting of the Southwestern Surgical Congress, in Tucson, AZ, April 27-30, 2003.

DOI
10.1016/j.amjsurg.2003.09.005
Citation Information
Jeffrey Nicholas, Mark W. Cornelius, Kathryn M. Tchorz, Lorraine N. Tremblay, et al.. "A Two Institution Experience With 226 Endoscopically Placed Jejunal Feeding Tubes in Critically Ill Surgical Patients" The American Journal of Surgery Vol. 6 (2003) p. 583 - 590 ISSN: 0002-9610
Available at: http://works.bepress.com/kathryn_tchorz/19/