遠隔的肥満外科手術歴を有する患者における外科的経管栄養アクセスに関する調査

BackgroundPatients with a history of bariatric surgery present a challenge in obtaining surgical feeding access due to altered gastrointestinal anatomy after these procedures. The aim of this study was to evaluate provider practice patterns for feeding tube access in bariatric patients.MethodsPatients with a history of either Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy who required surgical feeding access remote from their bariatric surgery were identified retrospectively at a single institution. Data on the nature of these procedures and their associated complications were obtained. A literature review was conducted on tube placement procedures after bariatric and foregut surgery and 11 publications were included.ResultsGastrostomy tubes (GTs) (n = 26/42, 61.9%) were placed most frequently, followed by jejunostomy tubes (JTs) (n = 13/42, 31.0%), and gastrojejunostomy tubes (n = 3/42, 7.1%). Most feeding tubes were placed in patients with a history of a RYGB (n = 29/38, 76.3%). General surgeons performed most of these procedures (n = 37/42, 88.1%). Feeding tube-associated complications were reported in most cases (n = 22/42, 52.4%). Two patients receiving JTs after sleeve gastrectomy developed aspiration pneumonia (n = 2/42, 4.8%).DiscussionThis study highlights the need for further research on surgical feeding access in patients with a history of bariatric surgery. Larger, prospective studies may help to define guidelines for feeding tube access in bariatric patients.