Patients with major upper gastrointestinal (UGI) resections that were made nil by mouth for 7-10 days postoperatively with pre-existing weight loss and depleted energy reserves in addition to increased metabolic rate needs nutritional support which serves to shorten the postoperative recovery phase and minimizes the number of complications. This may be supplemented by total parenteral nutrition (TPN) which is not available in our hospitals for over a decade. This problem led us to use a feeding jejunostomy tube after major resections for UGI malignancies.
This is a prospective study conducted between May 1999 and December 2004 at First Surgical Unit, Basrah General Hospital. The study aimed to examine the efficacy of Enteral Tube Feeding (ETF) as a method of nutritional support in patients with major resections for UGI malignancies.
A total of 76 patients, 42 males and 34 females. Mean age, 50 years (range, 27-72 years) underwent major UGI resections for gastric(64), oesophageal (10) and pancreatic(2) malignancies. ETF lasted for 12-41 days with diarrhoea and abdominal discomfort were the major complications in 14 and 8 patients respectively. .Diarrhoeal tolerance was established in 12 out of 14 patients and controlled in the other two by antidiarrhoeal drugs. There were improved body weight and serum albumin level after ETF and no septic complications or related mortality. ETF is a safe, feasible, cost effective, with few controllable complications rendering it a satisfactory alternative to total parenteral nutrition.