Comparative evaluation of nasoenteral feeding and jejunostomy feeding in acute corrosive injury: a retrospective analysis
Received 1 November 2008; accepted 5 March 2009. published online 02 July 2009.
Background
Nutritional support in corrosive injury patients is traditionally achieved through total parenteral nutrition (TPN) or jejunostomy feeding (JF). There are no reports of nasoenteral tube feeding in patients with corrosive ingestion.
Objective
We report our experience with nasoenteral tube feeding (NETF) and compare the outcome of these patients with those undergoing JF.
Setting
Tertiary medical center in North India.
Design and Intervention
The records of 53 and 43 patients with severe acute corrosive injury who underwent NETF and JF, respectively, were reviewed. All had received a 50-kcal/kg, 2-g/kg protein homogenized liquid diet for 8 weeks. A contrast study was performed at 8 weeks, and body weight and serum albumin levels were recorded at hospitalization and at 8 weeks.
Main Outcome Measurements
Change in weight and serum albumin at 8 weeks and stricture development rate.
Results
Strictures developed in 41 (80.39%) and 36 (83.72%) patients in the NETF and JF groups, respectively. Development of esophageal stricture (P = .71) and gastric stenosis (P = .89) was comparable in the 2 groups. No significant changes in serum albumin and weight were noted at 8 weeks in either group. The complication rate was lower in the NETF group compared with the JF group. Although all of the patients in the NETF group had a patent lumen, 5 in the JF group had total obstruction precluding endoscopic intervention.
Limitations
Retrospective study design.
Conclusion
NETF is as effective as JF in maintaining nutrition in patients with severe corrosive injury. The stricture development rate is similar, but nasoenteral tube placement provides a lumen for dilatation should a tight stricture develop.
Current affiliations: Department of Gastroenterology (R.K., K.S.P., P.P., U.D., S.K.S., P.K.S., B.N., K.S.) and Department of General Surgery (J.D.W.), Postgraduate Institute of Medical Education and Research, Chandigarh, India
Reprint requests: Rakesh Kochhar, MD, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India.
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
If you would like to chat with an author of this article, you may contact him at dr_kochhar@hotmail.com.
ABSTRACT