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Purpose <p>The role of prophylactic feeding jejunostomy (FJ) after major upper gastrointestinal (GI) surgery remains debated due to concerns over procedure-related complications. This prospective observational study aimed to evaluate the safety and efficacy of prophylactic FJ in patients undergoing major upper GI cancer surgery, with special emphasis on complication profile and the impact of duration on FJ retention.</p> Methods <p>We prospectively analyzed 128 consecutive patients who underwent prophylactic FJ as part of major upper GI cancer surgeries between July 2024 and July 2025 at a tertiary referral cancer center. The primary endpoints were FJ-related morbidity and mortality. Secondary analysis was comparison of complication rates between patients with FJ removed within 50 days and those retained beyond 50 days.</p> Results <p>FJ-related complications occurred in 43 patients (33.6%), of whom 95.3% (<i>n</i> = 41) had Clavien–Dindo grade I complications managed conservatively, and 2 required surgical intervention (misplacement of FJ in proximal jejunal limb and jejuno-jejunal intussusception). The most frequent events were minor peritubal leaks (19.5%) and incidental tube dislodgement (7.8%). There was no 30 days FJ-related mortality. There was no significant difference in complication rates between patients with FJ removed within 50 days (<i>n</i> = 90) and those retained beyond 50 days (<i>n</i> = 38) (<i>P</i> = 0.26). No patients with FJ required parenteral nutrition. Median follow up was 4 months (range 0.5–12).</p> Conclusions <p>Prophylactic FJ is safe and associated with a low rate of major morbidity. Most complications are minor and managed conservatively. When postoperative complications delay oral intake, FJ allows achievement of nutritional targets, and prolonged retention does not significantly increase complication rates.</p>

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Safety of Feeding Jejunostomy in Patients Undergoing Major Upper Gastrointestinal Surgeries

  • 期刊论文

  • 发表日期：

    2026年5月2日

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  • Thammineedi Subramanyeshwar Rao,
  • Sujit Chyau Patnaik,
  • Srijan Sandesh Shukla,
  • Naga Venkata Ranjith Kumar,
  • Shri Siddhartha Nekkanti,
  • Rajesh Kumar Jarang,
  • Sharad Ashok Jadhav,
  • Praveena Reddy Avuthu,
  • Rashiv Bhardwaj,
  • Anil Choudhary,
  • Syed Nusrath

摘要

Purpose

The role of prophylactic feeding jejunostomy (FJ) after major upper gastrointestinal (GI) surgery remains debated due to concerns over procedure-related complications. This prospective observational study aimed to evaluate the safety and efficacy of prophylactic FJ in patients undergoing major upper GI cancer surgery, with special emphasis on complication profile and the impact of duration on FJ retention.

Methods

We prospectively analyzed 128 consecutive patients who underwent prophylactic FJ as part of major upper GI cancer surgeries between July 2024 and July 2025 at a tertiary referral cancer center. The primary endpoints were FJ-related morbidity and mortality. Secondary analysis was comparison of complication rates between patients with FJ removed within 50 days and those retained beyond 50 days.

Results

FJ-related complications occurred in 43 patients (33.6%), of whom 95.3% (n = 41) had Clavien–Dindo grade I complications managed conservatively, and 2 required surgical intervention (misplacement of FJ in proximal jejunal limb and jejuno-jejunal intussusception). The most frequent events were minor peritubal leaks (19.5%) and incidental tube dislodgement (7.8%). There was no 30 days FJ-related mortality. There was no significant difference in complication rates between patients with FJ removed within 50 days (n = 90) and those retained beyond 50 days (n = 38) (P = 0.26). No patients with FJ required parenteral nutrition. Median follow up was 4 months (range 0.5–12).

Conclusions

Prophylactic FJ is safe and associated with a low rate of major morbidity. Most complications are minor and managed conservatively. When postoperative complications delay oral intake, FJ allows achievement of nutritional targets, and prolonged retention does not significantly increase complication rates.