Role of jejunostomy feeding catheter as a model for nutritional support

Introduction: The advancement in oesophageal cancer care during the last two decades has resulted in a decrease in the use of feeding jejunostomy catheter to maintain adequate nutrition. We aim to examine the validity of feeding jejunostomy catheter in maintaining adequate nutrition for patients with oesophageal cancer. Patients and Methods: A prospective longitudinal study was conducted on oesophageal cancer patients presenting to Khartoum Teaching Hospital with complete dysphagia between June 2005 and September 2007. Nutritional assessment was performed pre- and post-insertion of the feeding jejunostomy catheter and data were tested for any significant difference. Results: Among 99 patients enrolled in the study, 48 had the feeding catheter inserted during oesophagectomy, 41 prior to neoadjuvant therapy and 10 as a palliative measure. Catheter dislodgement occurred in 3% of patients while blockage occurred in 10% and migration in only 1%. The mean +/- SD of patients' weight pre-insertion was 48.08 +/- 10.29, while the mean +/- SD weight on day 10 post-insertion was 48.41 +/- 10.27 and on day 30 was 48.14 +/- 10.29. Patients on jejunostomy catheter feeding were considered optimised to receive neoadjuvant therapy based on clinical assessment, mobility and sense of well being. The post-resection mortality rate was 11.5% vs 10% compared to patients on oral feeding. Conclusion: Jejunostomy feeding catheter provided nutritional access to oesophageal cancer patients with complete dysphagia using a locally prepared formula. Patients managed to maintain their weight up to 30 days post-insertion of the feeding catheter. Feeding jejunostomy catheter in combination with a locally prepared feeding formula provided a reliable nutritional option for oesophageal cancer patients in developing countries. (C) 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.