How I do it - Needle catheter jejunostomy at esophagectomy for cancer

Important physiological changes occur after major abdominal surgery. Cellular and morphological changes follow a period of malnutrition. Enteral feeding is an important strategy for maintaining gut integrity and function. Controversies remain on the use of feeding jejunostomy after major abdominal surgery and its use had not gained widespread acceptance. The records of 262 consecutive patients who underwent esophagectomy for cancer were reviewed retrospectively to assess whether the placement of a needle catheter jejunostomy (NCJ) at the time of surgery is a safe and useful procedure. All the patients had a 9 Fr. NCJ place in a standardized fashion at the time of the esophagectomy. The technique of placement, the utilisation, and the complications of the NCJ were examined. The enteral nutrition was started in the first post-operative day. Sixty-three percent of our patients required enteral nutrition for 10 or more days. In 19%, this requirement was prolonged for more then 20 days, upto 68 days. The complications related to NCJ were four (1.5%). The use of the NCJ as described is safe, with an extremely low rate of complications. It may provide adequate nutritional support for a prolonged period of time at low costs. Its routine use in patients undergoing esophagectomy is recommended.