PMID- 29748126
OWN - NLM
STAT- MEDLINE
DCOM- 20190102
LR  - 20190102
IS  - 1878-7533 (Electronic)
IS  - 1550-7289 (Linking)
VI  - 14
IP  - 7
DP  - 2018 Jul
TI  - Feeding the gut after revisional bariatric surgery: The fate of 126 enteral 
      access tubes.
PG  - 986-991
LID - S1550-7289(18)30131-X [pii]
LID - 10.1016/j.soard.2018.03.008 [doi]
AB  - BACKGROUND: Revisional bariatric surgery (RBS) is associated with higher 
      complication rates compared with primary bariatric surgery. Feeding tubes (FTs), 
      including gastrostomy and jejunostomy tubes placed during RBS, may serve as a 
      safety net to provide nutrition when oral intake is contraindicated or limited; 
      however, FTs in this setting have not been well investigated. OBJECTIVES: This 
      study aims to determine complications, use, and duration of FTs placed during 
      RBS. SETTING: A high-volume academic medical center in the United States. 
      METHODS: Included patients underwent RBS between January 2008 and December 2016 
      with FTs placed at the time of RBS. RESULTS: There were 126 patients identified 
      (84.9% female, 76.2% Caucasian, mean age 53.4-+/-10.9 yr). Patients had previously 
      undergone Roux-en-Y gastric bypass (34.1%), vertical banded gastroplasty (27.8%), 
      and adjustable gastric band (14.3%). Indications for RBS included correction of 
      complication of prior bariatric surgeries (50%), weight regain/failure to lose 
      weight (32.3%), or both (17.3%). Most FTs were placed in the excluded stomach 
      (89.7%), and median tube size was 18 F. FTs were used for feeding in 68.2% of 
      patients, with feeding initiated in a median of 2 days. Leakage around the tube 
      (32.5%) and pain (26.8%) were common complaints. Significant tube-related 
      complications included infection (9.1%), dislodgement (5.9%), reintervention 
      (5.8%), and reoperation (2.8%); 16.7% experienced at least 1 significant 
      complication. FTs were removed at a median of 36 days. CONCLUSION: FTs may aid in 
      prevention of perioperative dehydration and malnutrition after RBS, but should 
      not be considered a benign intervention. FT use should be balanced against 
      institutional outcomes and care goals.
CI  - Copyright (c) 2018 American Society for Bariatric Surgery. Published by Elsevier 
      Inc. All rights reserved.
FAU - Strong, Andrew T
AU  - Strong AT
AD  - Department of General Surgery; Digestive Disease and Surgery Institute, Cleveland 
      Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine, Case 
      Western Reserve University, Cleveland, Ohio. Electronic address: stronga@ccf.org.
FAU - Fayazzadeh, Hana
AU  - Fayazzadeh H
AD  - Department of General Surgery; Digestive Disease and Surgery Institute, Cleveland 
      Clinic, Cleveland, Ohio.
FAU - Sharma, Gautam
AU  - Sharma G
AD  - Department of General Surgery; Digestive Disease and Surgery Institute, Cleveland 
      Clinic, Cleveland, Ohio.
FAU - El-Hayek, Kevin
AU  - El-Hayek K
AD  - Department of General Surgery; Digestive Disease and Surgery Institute, Cleveland 
      Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine, Case 
      Western Reserve University, Cleveland, Ohio.
FAU - Kroh, Matthew
AU  - Kroh M
AD  - Department of General Surgery; Digestive Disease and Surgery Institute, Cleveland 
      Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine, Case 
      Western Reserve University, Cleveland, Ohio; Digestive Disease Institute, 
      Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
FAU - Rodriguez, John
AU  - Rodriguez J
AD  - Department of General Surgery; Digestive Disease and Surgery Institute, Cleveland 
      Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine, Case 
      Western Reserve University, Cleveland, Ohio.
LA  - eng
PT  - Journal Article
DEP - 20180309
PL  - United States
TA  - Surg Obes Relat Dis
JT  - Surgery for obesity and related diseases : official journal of the American 
      Society for Bariatric Surgery
JID - 101233161
SB  - IM
MH  - Academic Medical Centers
MH  - Adult
MH  - Bariatric Surgery/*adverse effects/*methods
MH  - *Body Mass Index
MH  - Cohort Studies
MH  - Enteral Nutrition/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Gastric Bypass/adverse effects/methods
MH  - Gastroplasty/adverse effects/methods
MH  - Hospitals, High-Volume
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/diagnosis/*surgery
MH  - Postoperative Complications/diagnosis/surgery
MH  - Reoperation/methods
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Time Factors
MH  - Treatment Outcome
MH  - United States
OTO - NOTNLM
OT  - Complications
OT  - Enteral access
OT  - Feeding tube
OT  - Revisional bariatric surgery
EDAT- 2018/05/12 06:00
MHDA- 2019/01/03 06:00
CRDT- 2018/05/12 06:00
PHST- 2017/12/12 00:00 [received]
PHST- 2018/03/02 00:00 [revised]
PHST- 2018/03/06 00:00 [accepted]
PHST- 2018/05/12 06:00 [pubmed]
PHST- 2019/01/03 06:00 [medline]
PHST- 2018/05/12 06:00 [entrez]
AID - S1550-7289(18)30131-X [pii]
AID - 10.1016/j.soard.2018.03.008 [doi]
PST - ppublish
SO  - Surg Obes Relat Dis. 2018 Jul;14(7):986-991. doi: 10.1016/j.soard.2018.03.008. 
      Epub 2018 Mar 9.