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Aspiration pneumonia following surgically placed feeding tubes
K A Fox1, R A Mularski, M R Sarfati
1Department of Surgery, University of Arizona Health Sciences Center, Tucson, USA.
American Journal of Surgery
|December 1, 1995
Summary
Gastrostomy and jejunostomy feeding tube placements show similar aspiration pneumonia risks. Clinical factors, not just tube type, should guide surgical feeding tube decisions for better patient outcomes.
Area of Science:
- Gastroenterology
- Surgical Nutrition
- Critical Care Medicine
Background:
- Enteral nutrition is preferred for surgical patients.
- Jejunostomy was thought to reduce aspiration pneumonia risk compared to gastrostomy.
- Recent evidence questions the established practices of feeding tube placement.
Purpose of the Study:
- To compare complication rates, specifically aspiration pneumonia, between gastrostomy and jejunostomy.
- To evaluate the necessity of reevaluating current surgical feeding tube placement practices.
Main Methods:
- Retrospective chart review of gastrostomy and jejunostomy procedures (1986-1993).
- Analysis of demographic information and procedure-related complications.
- Aspiration pneumonia defined by clinical symptoms, leukocytosis, and chest radiograph findings.
Main Results:
- 69 gastrostomies and 86 jejunostomies were performed.
- 6 patients developed aspiration pneumonia (4 gastrostomy, 2 jejunostomy).
- No statistically significant difference in aspiration pneumonia rates between the two procedures (P = not significant).
Conclusions:
- Gastrostomy and jejunostomy exhibit comparable rates of pulmonary aspiration and other complications.
- Surgical feeding tube placement decisions should prioritize clinical factors like technical difficulty and long-term goals over assumed risks.