Aspiration pneumonia following surgically placed feeding tubes

Background: The enteral route is preferred in surgical patients requiring nutritional support; however, controversy surrounds the choice of location of feeding tube placement. Although jejunostomy has been commonly accepted as superior to gastrostomy for long-term nutritional support because of an a...

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Bibliographic Details
Published in:The American journal of surgery 1995-12, Vol.170 (6), p.564-567
Main Authors: Fox, Kenneth A., Mularski, Richard A., Sarfati, Mark R., Brooks, Maureen E., Warneke, James A., Hunter, Glenn C., Rappaport, William D.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Complications
Enteral Nutrition - adverse effects
Feeding
Gastrostomy - adverse effects
Humans
Jejunostomy - adverse effects
Leukocytosis
Medical sciences
Middle Aged
Ostomy
Pneumology
Pneumonia
Pneumonia, Aspiration - etiology
Respiratory system : syndromes and miscellaneous diseases
Retrospective Studies
Tubes
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Summary:Background: The enteral route is preferred in surgical patients requiring nutritional support; however, controversy surrounds the choice of location of feeding tube placement. Although jejunostomy has been commonly accepted as superior to gastrostomy for long-term nutritional support because of an assumed lower risk of aspiration pneumonia, recent studies suggest that reevaluation of common practices of surgical tube placement is warranted. Patients and methods: We conducted a retrospective chart review of gastrostomy and jejunostomy procedures from 1986 to 1993. Demographic information and complications related to the procedure were reviewed. Aspiration pneumonia was defined as respiratory symptoms, leukocytosis, and infiltrate on chest radiograph. Results: Sixty-nine gastrostomies and 86 jejunostomies were performed during the study period. Six patients were diagnosed with aspiration pneumonia; 2 cases of which occurred with jejunostomy and 4 cases occurred with gastrostomy ( P = not significant). Conclusions: There was no difference in rates of pulmonary aspiration or other complications between gastrostomy and jejunostomy. We suggest that when a surgically placed feeding tube is required, the determination of appropriate procedure be based on clinical factors such as the technical difficulty of the operation or long-term feeding goals.
ISSN:0002-9610
1879-1883
DOI:10.1016/S0002-9610(99)80016-6