Increased Rate of Serum Prealbumin Level after Preoperative Enteral Nutrition as an Indicator of Morbidity in Gastrectomy for Gastric Cancer with Outlet Obstruction

2022 ◽  
Author(s):  
Daisuke Izumi ◽  
Satoshi Ida ◽  
Masaru Hayami ◽  
Rie Makuuchi ◽  
Koshi Kumagai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Enteral Nutrition ◽  
Outlet Obstruction

scholarly journals Nasojejunal Feeding Is Safe and Effective Alternative to Feeding Jejunostomy for Postoperative Enteral Nutrition in Gastric Cancer Patients

2020 ◽  
Vol 9 (02) ◽  
pp. 070-073
Author(s):  
Kalita Deepjyoti ◽  
Srinivas Bannoth ◽  
Joydeep Purkayastha ◽  
Bibhuti B. Borthakur ◽  
Abhijit Talukdar ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Enteral Nutrition ◽  
Tube Feeding ◽  
Definitive Treatment ◽  
Feeding Jejunostomy ◽  
Causes Of Mortality ◽  
Nasojejunal Feeding ◽  
Gastric Cancer Patients ◽  
Bile Leaks ◽  
Technical Safety

Abstract Background and Aim Carcinoma of the stomach is one of the leading causes of mortality worldwide. Surgery for gastric cancer in the form of total or distal gastrectomy is definitive treatment. Feeding jejunostomy (FJ) though improves postoperative nutritional status and outcome, it is not devoid of its complications. In this study, we present the outcomes of nasojejunal (NJ) feeding and FJ and complications associated with them. Materials and Methods It is both retrospective and prospective observational study in patients with gastric cancer undergoing surgery. Patients were divided into two groups: those who underwent FJ and those who underwent NJ route of feeding placed intraoperatively. Results A total of 279 patients of gastric cancer who underwent surgery were taken into study, of which, 165 were male and 114 females. FJ was done in 42 and NJ in 237 patients, respectively. Gastrectomy + NJ was done in 128 patients, gastrectomy + FJ in 27 patients, gastrojejunostomy + NJ in 109 patients, and FJ in 15 patients. We had three patients of bile leaks in FJ group, of which one patient had intraperitoneal leak who needed re-exploration; rest of the two had peri-FJ external leaks, who were managed conservatively. Most of the complications of NJ group were minor. Conclusion Our study of 279 patients in gastric cancer has shown that FJ is sometimes associated with major complications with increased hospital stay and morbidity when compared with NJ tube feeding without any difference in nutritional outcomes. Hence, NJ route of postoperative enteral nutrition can be considered as an alternative to FJ wherever feasible in view of its technical safety and minor complications and morbidity.

scholarly journals Modified Devine Exclusion for Unresectable Distal Gastric Cancer in Symptomatic Patients

2017 ◽  
Vol 11 (1) ◽  
pp. 9-16 ◽  
Author(s):  
María Carmen Fernández-Moreno ◽  
Roberto Martí-Obiol ◽  
Fernando López ◽  
Joaquín Ortega
Keyword(s):  
Gastric Cancer ◽  
Oral Tolerance ◽  
Outlet Obstruction ◽  
Postoperative Mortality ◽  
Palliative Surgery ◽  
Alternative Methods ◽  
Blood Transfusions ◽  
Safe Procedure ◽  
Severe Anemia ◽  
Distal Gastric Cancer

Background: In patients with outlet obstruction syndrome and/or severe anemia secondary to unresectable gastric cancer (GC), partial stomach-partitioning gastrojejunostomy, or modified Devine exclusion, is a surgical alternative. Methods: A retrospective study was conducted on patients with unresectable distal GC treated with modified Devine exclusion as palliative surgery between February 2005 and December 2015. It consisted of a series of 10 patients with outlet obstruction syndrome and/or severe anemia. The outcomes of this technique were based on oral tolerance, blood transfusions, postoperative complications, and survival. Results: Early oral tolerance and a low rate of blood transfusions were observed postoperatively. There was no postoperative mortality and a very low complication rate without anastomotic leakage. Median survival was 9 months. Conclusions: Partial stomach-partitioning gastrojejunostomy is a safe procedure for unresectable GC which can improve the quality of life of these patients.

scholarly journals Peri-operative Outcomes and Survival Following Palliative Gastrectomy for Gastric Cancer: a Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Joseph Cowling ◽  
Bethany Gorman ◽  
Afrah Riaz ◽  
James R. Bundred ◽  
Sivesh K. Kamarajah ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Survival Data ◽  
Meta Analysis ◽  
Outlet Obstruction ◽  
Survival Outcomes ◽  
Operative Outcomes ◽  
Palliative Gastrectomy ◽  
Resectional Surgery ◽  
Improvement In Survival

Abstract Background Many patients with gastric cancer present with late stage disease. Palliative gastrectomy remains a contentious intervention aiming to debulk tumour and prevent or treat complications such as gastric outlet obstruction, perforation and bleeding. Methods We conducted a systematic review of the literature for all papers describing palliative resections for gastric cancer and reporting peri-operative or survival outcomes. Data from peri-operative and survival outcomes were meta-analysed using random effects modelling. Survival data from patients undergoing palliative resections, non-resective surgery and palliative chemotherapy were also combined. This study was registered with the PROSPERO database (CRD42019159136). Results One hundred and twenty-eight papers which included 58,675 patients contributed data. At 1 year, there was a significantly improved survival in patients who underwent palliative gastrectomy when compared to non-resectional surgery and no treatment. At 2 years following treatment, palliative gastrectomy was associated with significantly improved survival compared to chemotherapy only; however, there was no significant improvement in survival compared to patients who underwent non-resectional surgery after 1 year. Palliative resections were associated with higher rates of overall complications versus non-resectional surgery (OR 2.14; 95% CI, 1.34, 3.46; p < 0.001). However, palliative resections were associated with similar peri-operative mortality rates to non-resectional surgery. Conclusion Palliative gastrectomy is associated with a small improvement in survival at 1 year when compared to non-resectional surgery and chemotherapy. However, at 2 and 3 years following treatment, survival benefits are less clear. Any survival benefits come at the expense of increased major and overall complications.

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