Decompressive tube jejunogastrostomy after esophagectomy for carcinoma

Abstract

Background/aims: Gastric distension after esophagectomy and reconstruction with gastric conduit can promote both pulmonary complications and conduit ischaemia. The aim of this paper is to present a method of retrograde transjejunal decompression, with special emphasis on surgical technique and specific technique-related complications.

Methodology: In the period from January 2005 to December 2008 we prospectively evaluated 95 patients who underwent esophagectomy for carcinoma. In all of these patients decompressive jejunogastrostomy was employed.

Results: There was no peritonitis or re-operation due to the decompressive tube placement, the most common complication that occurred was cellulitis and it was present in 7 patients. Decompressive tube was usefull in preventing postoperative gastric conduit distension. No patient complained of discomfort due to the jejunogastric tube placement. Postoperative pneumonia developed in 8 patients (8.4%).

Conclusions: We believe that the usage of jejunogastric tube decompression during the open esophagectomy is a safe, simple and useful technique, which improves postoperative recovery, and possibly reduces respiratory complications.