Our Summary

This research paper examines a surgical procedure known as feeding jejunostomy, which is often performed during major surgeries involving the esophagus and stomach. This procedure provides nutritional support to patients after their surgery. However, it can sometimes lead to serious complications, including damage to the small intestine. The study aimed to understand how often this happens and whether the risk differs between patients who have surgery on their esophagus versus their stomach.

The study looked at data from patients who had this type of surgery at Leicester Royal Infirmary between 2009 and 2015. The results showed that none of the patients who had esophagus surgery experienced complications with their small intestine. However, six patients who had stomach surgery did experience this complication. This happened despite all patients receiving the same feeding plan after surgery.

All six patients who experienced this complication needed further surgery, and most required a special type of nutrition delivered through a vein for 6-8 weeks. Only one patient showed signs of this complication before it happened. The other five patients didn’t show any signs in the two days before the complication occurred.

The study concludes that damage to the small intestine is a serious risk of feeding jejunostomy, especially for patients who have stomach surgery. The authors recommend early use of CT scanning and a return to the operating room if signs of this complication appear. They suggest that the presence of air pockets in the intestines on a CT scan should prompt immediate surgical action, as it can improve the patient’s chances of survival.

FAQs

  1. What is a feeding jejunostomy and why is it performed?
  2. What complications can occur from a feeding jejunostomy, and how often do they occur?
  3. What precautions or measures are recommended to minimize the risk of complications with feeding jejunostomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about bowel resection is to follow post-operative instructions closely, including taking prescribed medications, eating a healthy diet, staying hydrated, and attending follow-up appointments. It’s also important to watch for signs of complications, such as increased pain, fever, or changes in bowel habits, and to seek medical attention if any concerning symptoms arise. By following these guidelines, patients can help ensure a successful recovery after bowel resection surgery.

Suitable For

Patients who are typically recommended for bowel resection include those with conditions such as:

  • Colorectal cancer
  • Crohn’s disease
  • Ulcerative colitis
  • Diverticulitis
  • Bowel obstruction
  • Intestinal bleeding
  • Perforation of the bowel

These conditions may require surgical intervention to remove diseased or damaged portions of the bowel. Bowel resection may also be recommended for patients who have experienced trauma to the abdomen or have complications from previous surgeries. It is important for patients to discuss their individual circumstances with their healthcare provider to determine if bowel resection is the best treatment option for them.

Timeline

Before bowel resection:

  • Patient is diagnosed with a condition that requires bowel resection surgery
  • Patient undergoes preoperative testing and preparation
  • Patient discusses the procedure with their healthcare provider and receives information on what to expect
  • Surgery is scheduled and patient is admitted to the hospital
  • Patient undergoes bowel resection surgery

After bowel resection:

  • Patient is monitored closely in the hospital for any complications
  • Patient may have a nasogastric tube to help with bowel rest and drainage
  • Patient starts on a clear liquid diet and gradually progresses to solid foods
  • Patient may experience pain, discomfort, and changes in bowel habits
  • Patient is discharged from the hospital once stable
  • Patient follows a specific diet and exercise plan to aid in recovery
  • Patient may need follow-up appointments with their healthcare provider for monitoring and support.

What to Ask Your Doctor

Some questions a patient should ask their doctor about bowel resection include:

  1. What is the reason for recommending a bowel resection?
  2. What are the potential risks and complications associated with this surgery?
  3. How long is the recovery process expected to take?
  4. Will I need a temporary ostomy or stoma after the surgery?
  5. What dietary changes or restrictions will I need to follow post-surgery?
  6. What type of follow-up care will be required after the procedure?
  7. Are there any alternative treatments or procedures that could be considered?
  8. How many bowel resections have you performed, and what is your success rate?
  9. What signs or symptoms should I watch out for that may indicate a complication after the surgery?
  10. Will I need any additional support or resources during my recovery period?

Reference

Authors: Al-Taan OS, Williams RN, Stephenson JA, Baker M, Murthy Nyasavajjala S, Bowrey DJ. Journal: J Gastrointest Surg. 2017 Sep;21(9):1385-1390. doi: 10.1007/s11605-017-3438-6. Epub 2017 Jun 23. PMID: 28646333