A comparison between open and laparoscopic feeding jejunostom

Abstract

Introduction: Corrosive intake is a social dilemma in our society and it is a leading cause of morbidity due to malnutrition caused by inability to feed through natural route in the victims. Some kind of procedure is needed to reestablish the natural route in survivors. This is usually accomplished by feeding jejunostomy mostly done by open method.

Objective: This study was meant to compare the outcome of LFJ and OFJ.

Materials and Method: This prospective randomized controlled trial was carried out at PGMI / AMC / LGH, Lahore for 1 year. During the period total of 60 patients were selected. In Gp A the LFJ while in Gp B the OFJ was performed. Outcomes of both were compared for pain, infection, bleeding, duration and cost of procedure. DM, HTN and ASA grades were accounted for while performing logistic regression. Age and sex stratification for outcome analysis was done. This study was approved by the ethical review committee of LGH, Lahore.

Results: The mean age of all cases was 27.70 ± 9.79 years. The male to female ratio was 1:5. After 72 hours of surgery, 1 (3.3%) cases in LFJ and 27 (86.67%) cases in OFJ had pain with significantly lower pain in LFJ with a p-value < 0.001. Blood loss in LFJ was (11.03 ± 2.1 ml) as compared to OFJ (27.2 ± 5.4 ml). After 2 wks one of the cases (3.3%) in LFJ and 6 (20.0%) cases in OFJ had infection with p-value < 0.05. Mean time for LFJ (47.4 ± 4.3 min) was less than needed for OFJ (58.6 ± 7.7 min).

Conclusion: It was concluded that LFJ was better than OFJ in terms of having less pain, bleeding, infection and duration of procedure, while cost of LFJ was exceptionally high.