COMPLICACIONES YEYUNOSTOMIA PDF

Faekazahn The principal aim of the journal is to publish original work in the broad field of Gastroenterology, as well as to provide information on the specialty and related areas that is up-to-date and relevant. Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery. Learn more about ebook formats and e-readers. Conclusion Before initiating this type of nutrition, it is advisable to assess the risk factors of bowel necrosis for each patient individually. Direct percutaneous endoscopic jejunostomy high completion rates with selective use of a long drainage Access needle.

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Los factores asociados significativamente con el desarrollo de complicaciones fueron obesidad, linfopenia e hipoalbuminemia.. Background: There are few studies in the literature that analyze jejunostomy complications and their associated factors.. Aims: To describe the rate of complications and analyze the factors associated with their development in a tertiary reference center in Mexico.. Methods: A retrospective study was carried out on patients that underwent Witzel jejunostomy within the time frame of January to December Patient demographic, clinical, and laboratory data were collected at the time of hospital admission and during follow-up.

The factors associated with the development of complications were analyzed using the chi square test for categorical variables and the Student's t test for the continuous variables. Results: One hundred and twelve patients 57 men with a mean age of Forty-eight patients The most frequent surgical complications were severe sepsis The factors that were significantly associated with the development of complications were obesity, lymphocytopenia, and hypoalbuminemia..

Conclusions: Jejunostomy is associated with an elevated medical, as well as surgical, complication frequency. Even though it has been established as a better alternative to parenteral nutrition, its associated morbidity should be taken into consideration before establishing its routine use as a means of nutritional support, especially in patients with factors associated with the development of complications..

Jejunostomy is a surgical procedure in which a tube is introduced into the proximal jejunal lumen for the fundamental purpose of providing nutrition.

The main indication for jejunostomy is as an additional procedure in the course of a major intervention in the upper gastrointestinal tract. Jejunostomy enables the initiation of enteral feeding in the first 24 postoperative hours, especially in patients at high risk for complications anastomosis leak, cicatrization delay , prolonged postoperative venti lation, polytrauma, pre-existing malnutrition, gastroparesis diabetes , post-pyloric obstruction, cranial trauma, and patients receiving chemotherapy and radiotherapy.

Like all surgical procedures, jejunostomy presents a risk for both medical and surgical complications. The principal secondary complications of a jejunostomy for enteral nutrition can be classified as mechanical, infectious, gastrointestinal, and metabolic. Knowledge of the factors associated with the development of these pathologic events will enable the pursuit of other feeding alternatives, such as a nasoenteral catheter or total parenteral nutrition, in at-risk patients.

The aim of the present study was to describe the complication rate of jejunostomy using the longitudinal Witzel technique performed at a tertiary referral center in Mexico and to analyze the factors associated with their development. A retrospective cross-sectional study was conducted on patients that underwent Witzel jejunostomy at a referral center in Mexico City within the time frame of January and December This type of jejunostomy was chosen for review because it is the technique most commonly employed in our institution; other jejunostomy methods are rarely used.

All the clinical case records involving this procedure were examined, regardless of the patient's age, sex, underlying disease, and comorbidities. The demographic, clinical, and laboratory data were collected upon hospital admission and during outpatient follow-up.

Patients that were admitted to our hospital due to jejunostomy complications were excluded from the study if their operation had been performed at another hospital. The complications associated with the jejunostomy and the factors involved in that event were the primary outcome of the study. The complications were those that occurred no longer than 30 days after surger y or release from medical care. The variables were defined as follows: patients over 65 years of age were regarded as the elderly, a body mass index BMI above 30 was associated with obesity, and malnutrition was an index under Septic shock was defined as the association between infection and hemodynamic failure, and in some cases, with visceral failure.

The SPSS version 19 program was used for the descriptive statistics with measures of central tendency and dispersion, in accordance with the distribution of the variables. The Student's t test was employed for the continuous variables and the chi-square test for the categorical variables. Statistical significance was considered with a p This study included patients 55 women and 57 men with a mean age of The most frequent ones were gastric cancer with 31 cases The rest of the causes are described in Table 1.

The mean of the BMI was Eight patients 7. The remaining 89 patients Other surgical interventions were carried out at the same time as the jejunostomy in 91 patients Of the patient total, 48 The number of surgical complications was 39 A total of 33 patients The remaining postoperative complications are described in Table 2.

Thirteen patients In the analysis of the factors associated with complications after the jejunostomy, obesity OR 2. On the other hand, lymphocytopenia was associated with the development of medical complications OR 1. Malnutrition is a significant problem in patients undergoing major gastrointestinal surgery.

Patients with neoplastic lesions of the upper digestive tract can arrive at surgery with a deficient nutritional status, which, along with the habitual postoperative prolonged fast, makes the implementation of nutritional support advisable.

Thus, providing nutrition has become a vital part of conventional postoperative care and is a customar y practice in many centers in which abdominal resection surgery is performed. In various randomized clinical trials and meta-analyses, postoperative enteral nutrition has been shown to be safer than parenteral nutrition and is associated with significantly lower postoperative morbidity.

It also preserves the enteric flora and results in the use of fewer resources. In our institution, the jejunostomy technique used almost exclusively is the Witzel technique. It is preferred to parenteral feeding because, as mentioned above, the use of the enteral route is associated with a lower number of complications, particularly infectious ones.

Because ours is a retrospective study and the choice of catheter placement depended on the attending physician in each particular case, we do not know if there were nutritional support alternatives to jejunostomy in each case, nor do we know why this route was chosen.

There is a risk for the development of complications with jejunostomy catheter placement, as there is with any surgical procedure. The clinical presentation of gastrointestinal symptoms was evaluated in both groups and the comparative study showed no significant differences between the 2 groups.

In our study, from the patient total, 48 Sepsis is reported in the medical literature as one of the most common complications. These are also reported as major complications in the medical literature. Hypoalbuminemia is one of the factors involved in the incidence of jejunostomy complications; it is also related to postoperative risk factors involving the digestive tract in cases of rectal cancer, colostomy, ileus, and hepatic complications.

Its role in acute pathology is not well understood, 35,36 making it a significant variable in major surgery; its presence prolongs hospital stay. Lymphocyte count has also been described as a general health status marker in these patients, as well as a malnutrition marker. In other studies it has been found to be a risk factor for the development of complications possibly due to a deficient immune response; it has also been described as a marker for general health status deterioration, including severe malnutrition.

In addition, obesity is a predisposing factor for the development of surgical complications, because tissues are more friable when there is a great quantity of fatty deposits, facilitating wound dehiscence or infection. In our study, both obesity and hypoalbuminemia doubled the risk for developing surgical complications in patients undergoing jejunostomy catheter placement.

The strengths of this study are that it is one of the few that has analyzed the factors associated with these complications, it was conducted in the same institution, and the postoperative progression was well documented. Perhaps we have overestimated the complication rate because in order to avoid study bias we included all complications that developed within a day postoperative time lapse.

At times it was very difficult to distinguish between complications associated with the jejunostomy per se vs. In conclusion, jejunostomy is associated with an elevated frequency of medical, as well as surgical, complications. Even though it has been established as a better alternative to parenteral nutrition, its associated morbidity must be taken into account before establishing its routine use as a means of nutritional support. This is especially true in the case of patients presenting with factors associated with the development of such complications, which in our study were obesity, hypoalbuminemia, and lymphocytopenia.

In patients with these risk factors, the nutritional support alternatives of nasoenteral catheter feeding and total parenteral nutrition are suggested. Vasco de Quiroga Tlalpan, Mexico City E-mail address: herimd hotmail. Descargar PDF. Medina-Franco , C. Rosales-Murillo , D. Table 1. Primary diagnosis for jejunostomy use.. Los factores asociados significativamente con el desarrollo de complicaciones fueron obesidad, linfopenia e hipoalbuminemia.

Palabras clave:. Background: There are few studies in the literature that analyze jejunostomy complications and their associated factors. Aims: To describe the rate of complications and analyze the factors associated with their development in a tertiary reference center in Mexico.

The factors that were significantly associated with the development of complications were obesity, lymphocytopenia, and hypoalbuminemia. Even though it has been established as a better alternative to parenteral nutrition, its associated morbidity should be taken into consideration before establishing its routine use as a means of nutritional support, especially in patients with factors associated with the development of complications.

Feeding jejunostomy; Enteral feeding; Complications; Risk factors. Texto completo. Introduction Jejunostomy is a surgical procedure in which a tube is introduced into the proximal jejunal lumen for the fundamental purpose of providing nutrition.

Methods A retrospective cross-sectional study was conducted on patients that underwent Witzel jejunostomy at a referral center in Mexico City within the time frame of January and December Statistical significance was considered with a p Results This study included patients 55 women and 57 men with a mean age of Jejunostomy: techniques, indications, and complications..

World J Surg. Complications of needle catheter jeunostomy in 2. Am J Surg. Direct percutaneous endoscopic jejunostomies for enteral feeding.. Nutr Clin Pract. Cir Esp. Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis..

Ann Surg.

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[Surgical Jejunostomy as Digestive Tube Access in the Long-Term]

Los factores asociados significativamente con el desarrollo de complicaciones fueron obesidad, linfopenia e hipoalbuminemia.. Background: There are few studies in the literature that analyze jejunostomy complications and their associated factors.. Aims: To describe the rate of complications and analyze the factors associated with their development in a tertiary reference center in Mexico.. Methods: A retrospective study was carried out on patients that underwent Witzel jejunostomy within the time frame of January to December Patient demographic, clinical, and laboratory data were collected at the time of hospital admission and during follow-up.

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COMPLICACIONES YEYUNOSTOMIA PDF

Enteral feeding via jejunostomy as a cause of intestinal perforation and necrosis. Hospital Universitario 12 de Octubre. Background: Jejunostomy for enteral feeding is excellent for patients who cannot manage oral intake, with a low complication rate. It is a safe procedure but it can lead to severe complications. Discussion: We have reviewed the recent literature with regard to this rare complication. Key words: Intestinal perforation.

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