Application of Laparoscopic Jejunostomy in Minimal Invasive McKeown Esophagectomy
Objective To evaluate the safety and clinical value of laparoscopic jejunostomy in minimal invasive McKeown esophagectomy. Methods The clinical data of the patients undergoing minimally invasive McKeown esophagectomy in the Department of Thoracic Surgery, Peking Union Medical College Hospital fro...
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| Format: | Article |
| Language: | zho |
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Editorial Office of Medical Journal of Peking Union Medical College Hospital
2022-09-01
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| Series: | Xiehe Yixue Zazhi |
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| Online Access: | https://xhyxzz.pumch.cn/en/article/doi/10.12290/xhyxzz.2021-0635 |
| _version_ | 1811226295401447424 |
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| author | ZHAO Luo HE Jia QIN Yingzhi HAN Zhijun LIU Hongsheng LI Shanqing LI Li |
| author_facet | ZHAO Luo HE Jia QIN Yingzhi HAN Zhijun LIU Hongsheng LI Shanqing LI Li |
| author_sort | ZHAO Luo |
| collection | DOAJ |
| description | Objective To evaluate the safety and clinical value of laparoscopic jejunostomy in minimal invasive McKeown esophagectomy. Methods The clinical data of the patients undergoing minimally invasive McKeown esophagectomy in the Department of Thoracic Surgery, Peking Union Medical College Hospital from January 2013 to June 2020 were retrospectively included, and according to postoperative nutritional support they were divided into oral intake group (January 2013 to October 2017) and jejunostomy group (November 2017 to June 2020). The operation time, postoperative hospital stay, complications, perioperative nutritional status and quality of life scores were compared between the two groups. Results A total of 190 patients with esophageal cancer who met the inclusion and exclusion criteria were enrolled. There were 128 cases in jejunostomy group and 62 cases in oral intake group. Compared with the patients in oral intake group, those in jejunostomy group had shorter postoperative hospitalization time [11(9, 13)d vs. 14(13, 20)d, P < 0.001], the completion rate of postoperative adjuvant chemotherapy in the jejunostomy group was higher(95.16% vs. 75.00%, P=0.005). The operation time [335(300, 374)min vs. 330(310, 370)min, P=0.750] and the incidence of surgery-related complications(28.13% vs. 35.48%, P=0.748) showed no significant difference between the two groups. The body mass index in jejunostomy group was higher 1 month [(23.3 ± 3.5)kg/m2 vs. (21.7±3.9)kg/m2, P=0.006] and 3 months[(22.6±3.5)kg/m2 vs. (20.6±4.0)kg/m2, P < 0.001] after surgery, and the body weight decreasing rate was lower 1 month [(3.9 ± 2.2)% vs. (10.3±3.5)%, P < 0.001] and 3 months[(6.5±3.1)% vs. (15.7 ± 4.8)%, P < 0.001] after surgery than those in oral intake group. The quality of life symptom scores in both groups were increased and the physical functioning and summary scores were sharply decreased at day 7 after operation, and all scores were improved in different degrees 1 month after operation. Compared with the measurements in oral intake group, the symptom scores (except pain score 1 month after operation) were decreased, and the physical functioning and summary scores were increased in the jejunostomy group 7 days and 1 month after operation (all P < 0.05). Conclusion Compared with oral nutrition, total laparoscopic jejunostomy has greater advantages in postoperative nutritional support and quality of life recovery in patients with esophageal cancer. It is also safe and unlikely to increase surgery-related complications. |
| first_indexed | 2024-04-12T09:22:48Z |
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| id | doaj.art-8e6b0fc5359440ab80d91b29ab632cb3 |
| institution | Directory Open Access Journal |
| issn | 1674-9081 |
| language | zho |
| last_indexed | 2024-04-12T09:22:48Z |
| publishDate | 2022-09-01 |
| publisher | Editorial Office of Medical Journal of Peking Union Medical College Hospital |
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| series | Xiehe Yixue Zazhi |
| spelling | doaj.art-8e6b0fc5359440ab80d91b29ab632cb32022-12-22T03:38:35ZzhoEditorial Office of Medical Journal of Peking Union Medical College HospitalXiehe Yixue Zazhi1674-90812022-09-0113584585110.12290/xhyxzz.2021-0635Application of Laparoscopic Jejunostomy in Minimal Invasive McKeown EsophagectomyZHAO LuoHE JiaQIN YingzhiHAN ZhijunLIU HongshengLI ShanqingLI LiObjective To evaluate the safety and clinical value of laparoscopic jejunostomy in minimal invasive McKeown esophagectomy. Methods The clinical data of the patients undergoing minimally invasive McKeown esophagectomy in the Department of Thoracic Surgery, Peking Union Medical College Hospital from January 2013 to June 2020 were retrospectively included, and according to postoperative nutritional support they were divided into oral intake group (January 2013 to October 2017) and jejunostomy group (November 2017 to June 2020). The operation time, postoperative hospital stay, complications, perioperative nutritional status and quality of life scores were compared between the two groups. Results A total of 190 patients with esophageal cancer who met the inclusion and exclusion criteria were enrolled. There were 128 cases in jejunostomy group and 62 cases in oral intake group. Compared with the patients in oral intake group, those in jejunostomy group had shorter postoperative hospitalization time [11(9, 13)d vs. 14(13, 20)d, P < 0.001], the completion rate of postoperative adjuvant chemotherapy in the jejunostomy group was higher(95.16% vs. 75.00%, P=0.005). The operation time [335(300, 374)min vs. 330(310, 370)min, P=0.750] and the incidence of surgery-related complications(28.13% vs. 35.48%, P=0.748) showed no significant difference between the two groups. The body mass index in jejunostomy group was higher 1 month [(23.3 ± 3.5)kg/m2 vs. (21.7±3.9)kg/m2, P=0.006] and 3 months[(22.6±3.5)kg/m2 vs. (20.6±4.0)kg/m2, P < 0.001] after surgery, and the body weight decreasing rate was lower 1 month [(3.9 ± 2.2)% vs. (10.3±3.5)%, P < 0.001] and 3 months[(6.5±3.1)% vs. (15.7 ± 4.8)%, P < 0.001] after surgery than those in oral intake group. The quality of life symptom scores in both groups were increased and the physical functioning and summary scores were sharply decreased at day 7 after operation, and all scores were improved in different degrees 1 month after operation. Compared with the measurements in oral intake group, the symptom scores (except pain score 1 month after operation) were decreased, and the physical functioning and summary scores were increased in the jejunostomy group 7 days and 1 month after operation (all P < 0.05). Conclusion Compared with oral nutrition, total laparoscopic jejunostomy has greater advantages in postoperative nutritional support and quality of life recovery in patients with esophageal cancer. It is also safe and unlikely to increase surgery-related complications.https://xhyxzz.pumch.cn/en/article/doi/10.12290/xhyxzz.2021-0635jejunostomyminimal invasive mckeown esophagectomyenteral nutritionlaparoscopic |
| spellingShingle | ZHAO Luo HE Jia QIN Yingzhi HAN Zhijun LIU Hongsheng LI Shanqing LI Li Application of Laparoscopic Jejunostomy in Minimal Invasive McKeown Esophagectomy Xiehe Yixue Zazhi jejunostomy minimal invasive mckeown esophagectomy enteral nutrition laparoscopic |
| title | Application of Laparoscopic Jejunostomy in Minimal Invasive McKeown Esophagectomy |
| title_full | Application of Laparoscopic Jejunostomy in Minimal Invasive McKeown Esophagectomy |
| title_fullStr | Application of Laparoscopic Jejunostomy in Minimal Invasive McKeown Esophagectomy |
| title_full_unstemmed | Application of Laparoscopic Jejunostomy in Minimal Invasive McKeown Esophagectomy |
| title_short | Application of Laparoscopic Jejunostomy in Minimal Invasive McKeown Esophagectomy |
| title_sort | application of laparoscopic jejunostomy in minimal invasive mckeown esophagectomy |
| topic | jejunostomy minimal invasive mckeown esophagectomy enteral nutrition laparoscopic |
| url | https://xhyxzz.pumch.cn/en/article/doi/10.12290/xhyxzz.2021-0635 |
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