Postoperative Morbidity and Mortality after Ivor Lewis Esophagectomy with and without Feeding Jejunostomy: A Retrospective Analysis
Background: Esophagectomy, particularly the Ivor Lewis procedure, remains a key surgical approach for esophageal carcinoma but is associated with significant postoperative risks. Feeding jejunostomy (FJ) is frequently used to ensure nutritional support; however, its routine placement is debated due to potential complications and unclear benefits. Methods: A retrospective comparative cross-sectional study was conducted at a tertiary care center in Dhaka, Bangladesh, from January 2022 to June 2023. Seventy patients with histologically confirmed esophageal cancer undergoing Ivor Lewis esophagectomy were included. Patients were divided into two groups: Group A (n=30) without FJ and Group B (n=40) with FJ. Demographic, clinical, operative, and postoperative data were analyzed using SPSS v25, with a p-value d” 0.05 considered statistically significant. Results: Baseline characteristics between the two groups were comparable. The operative time was significantly longer in Group B (336.25±40.11 minutes) compared to Group A (296.00±28.11 minutes; p=0.05). There were no significant differences in ICU stay, discharge weight, readmission rate, or mortality. Skin complications were noted exclusively in Group B (13.33%; p=0.04). No significant differences were observed in anastomotic leakage or mortality. Conclusions: Routine placement of feeding jejunostomy during Ivor Lewis esophagectomy does not appear to significantly enhance postoperative outcomes and may lead to an increased risk of local complications, such as skin infections. Therefore, selective use of FJ based on the patient’s nutritional status, comorbidities, and perioperative risk factors may be a more appropriate approach. Further prospective studies are warranted to validate these findings and guide clinical practice. Chest Heart J. 2024; 48(1) : 35-41