Location
LSU Health Sciences Center - New Orleans
Event Website
https://www.medschool.lsuhsc.edu/genetics/2024_medical_student_research_poster_symposium.aspx
Presentation Date
5-11-2024 9:30 AM
Description
Introduction: Bariatric surgeries are commonly performed procedures. Alteration of gastrointestinal anatomy with bariatric procedures can create challenges in subsequent patient management. Particularly, the placement of enteral feeding access such as gastrostomy (Gtube) or jejunostomy (J-tube) tubes can be challenging in this patient population. Currently, there are no guidelines regarding the placement of feeding access after bariatric surgery. This study aimed to investigate trends in feeding tube placement in remote bariatric surgery patients.
Methods: A retrospective multi-center chart review was conducted on adult patients with a history of either sleeve gastrectomy (gastric sleeve) or Roux-en-Y gastric bypass (RYGB) who subsequently required feeding access remote from their bariatric surgery from January 1, 2019 – January 1, 2024. Patient demographic and anthropometric data were recorded. Other data obtained were bariatric surgery history, location, approach of, and service providing feeding tube placement along with associated complications, reason for emergency department visit, hospital admission and length of stay, presence of aspiration pneumonia, days on a ventilator, and in-hospital mortality.
Results: A total of 29 patients were included with 32 feeding tubes placed. The patients were predominately female (n=27/29, 93.1%), with an average age of 51.1 +/- 11.3yrs and BMI of 35.1+/- 13.6 at the time of feeding tube placement. G tubes (n=19/32, 59.4%) were most commonly placed followed by J tubes (n=11/32, 34.4%) and GJ tubes (n=2/32, 6.3%). Due to complications, 3 patients had feeding tubes placed twice. G and J tubes were mostly placed in patients with history of a RYGB (n=24/32, 75.0%). The majority were placed by general surgeons. The 2 GJ-tubes placed were in a patient with history of RYGB and the other with history of a gastric sleeve. These procedures were performed by interventional radiology. Feeding tube associated complications were found in 68.8% of cases. The most common complications were leakage or clogging, which occurred in 46.8% of cases and occurred more frequently in patients who received a G-tube. 34.4% of feeding tubes became displaced or dislodged or required exchange or replacement. Our study identified 2 patients who developed aspiration pneumonia secondary to feeding tube placement, both received J-tubes and had a history of a gastric sleeve.
Conclusion: This study describes placement of feeding tubes in remote bariatric surgery patients, which is a challenging and understudied issue. It was found that most of these procedures are performed by bariatric surgeons. Larger studies are needed to develop guidelines.
Recommended Citation
Rumsey, Renee, "An Investigation of Surgical Feeding Access in Patients with Remote Bariatric Surgery" (2024). Medical Student Research Poster Symposium. 99.
https://digitalscholar.lsuhsc.edu/sommrd/2024MSRD/Posters/99
Included in
An Investigation of Surgical Feeding Access in Patients with Remote Bariatric Surgery
LSU Health Sciences Center - New Orleans
Introduction: Bariatric surgeries are commonly performed procedures. Alteration of gastrointestinal anatomy with bariatric procedures can create challenges in subsequent patient management. Particularly, the placement of enteral feeding access such as gastrostomy (Gtube) or jejunostomy (J-tube) tubes can be challenging in this patient population. Currently, there are no guidelines regarding the placement of feeding access after bariatric surgery. This study aimed to investigate trends in feeding tube placement in remote bariatric surgery patients.
Methods: A retrospective multi-center chart review was conducted on adult patients with a history of either sleeve gastrectomy (gastric sleeve) or Roux-en-Y gastric bypass (RYGB) who subsequently required feeding access remote from their bariatric surgery from January 1, 2019 – January 1, 2024. Patient demographic and anthropometric data were recorded. Other data obtained were bariatric surgery history, location, approach of, and service providing feeding tube placement along with associated complications, reason for emergency department visit, hospital admission and length of stay, presence of aspiration pneumonia, days on a ventilator, and in-hospital mortality.
Results: A total of 29 patients were included with 32 feeding tubes placed. The patients were predominately female (n=27/29, 93.1%), with an average age of 51.1 +/- 11.3yrs and BMI of 35.1+/- 13.6 at the time of feeding tube placement. G tubes (n=19/32, 59.4%) were most commonly placed followed by J tubes (n=11/32, 34.4%) and GJ tubes (n=2/32, 6.3%). Due to complications, 3 patients had feeding tubes placed twice. G and J tubes were mostly placed in patients with history of a RYGB (n=24/32, 75.0%). The majority were placed by general surgeons. The 2 GJ-tubes placed were in a patient with history of RYGB and the other with history of a gastric sleeve. These procedures were performed by interventional radiology. Feeding tube associated complications were found in 68.8% of cases. The most common complications were leakage or clogging, which occurred in 46.8% of cases and occurred more frequently in patients who received a G-tube. 34.4% of feeding tubes became displaced or dislodged or required exchange or replacement. Our study identified 2 patients who developed aspiration pneumonia secondary to feeding tube placement, both received J-tubes and had a history of a gastric sleeve.
Conclusion: This study describes placement of feeding tubes in remote bariatric surgery patients, which is a challenging and understudied issue. It was found that most of these procedures are performed by bariatric surgeons. Larger studies are needed to develop guidelines.
https://digitalscholar.lsuhsc.edu/sommrd/2024MSRD/Posters/99
Comments
Mentor: Dr. Alison A. Smith, MD, PhD LSUHSC, Department of Surgery