FREQUENCY OF COMPLICATIONS FOLLOWING TRANS HIATAL ESOPHAGECTOMY FOR ESOPHAGEAL CARCINOMA WITH OR WITHOUT FEEDING JEJUNOSTOMY

Abstract

Objective: To determine the benefit of feeding jejunostomy in patients under- going transhiatal esophagectomy in terms of complications.

Methodology: This prospective comparative (interventional) study was con- ducted in the Department of Surgery, Lady Reading Hospital, Peshawar, from 21st May, 2010 to 20th May, 2016. All patients with stage II and III esophageal carcinomas were included in the study. All patients were subjected to trans-hia- tal esophagectomy. Patients were placed into Group A (with a feeding jejunos- tomy) and B (without a feeding jejunostomy) by consecutive non-probability sampling technique. Anastomotic leak, hoarseness, chylothorax, fundal necro- sis; fistulation, abdominal pain, bloating, vomiting, pulmonary complications; and mortality over a period of 28 days was documented for each patient. With SPSS version 16.0, continuous data was subjected to student t test and Man Whitney U test whereas all the categorical data was compared using chi-square test and kruskal-Wallis test. A p value of <0.05 was considered significant.

Results: The total number of patients was 328 patients. These patients were equally divided resulting in 164 patients in each group. Patients from Group A were marginally older than patients from group B (p =0.89) and a non-sig- nificant male predominance was observed between the 02 groups (p =0.911). Significant differences were observed between the 02 groups regarding pulmo- nary complications, bloating and vomiting (p= 0.046). Mortality was significant- ly higher in the feeding jejunostomy group (7.4% Vs. 2.45%).

Conclusion: A significantly higher frequency of complications were observed in patients with feeding jejunostomies after transhiatal esophagectomy for esophageal cancer in terms of pulmonary complications and mortality.