Individual research recommendation details

Recommendation ID

NG83/4

Question

Jejunostomy support after radical surgery:- What is the effectiveness of long-term jejunostomy support compared to intensive dietary counselling and support along with symptom management for people having radical surgery for oesophago-gastric cancer?

Any explanatory notes
(if applicable)

Why this is important:- People who have had surgery for oesophago-gastric cancer have nutritional difficulties as a result of problems eating, ongoing symptoms, and side-effects related to the surgery. It is well recognised that they have a poor quality of life (QoL). Most patients have adjuvant treatment, however their nutritional status may negatively impact on their ability to tolerate this, meaning treatment can be stopped early or not received. Jejunostomy feeding tubes are often used to provide nutrition
support after discharge from hospital after surgery. Some small studies have shown a benefit in terms of weight preservation, but none have shown that this leads to better recovery, tolerance of treatment or quality of life. Practice in this area varies greatly, with some centres placing jejunostomy tubes and continuing enteral feeding after discharge, some placing the jejunostomy tubes and not using them routinely and others not placing jejunostomy tubes at all. Studies should aim to identify if jejunostomy placement leads to clinical benefit in adults who have had surgery for oesophago-gastric cancer.

Source guidance details

Comes from guidance

Oesophago-gastric cancer: assessment and management in adults

Number

NG83

Date issued

January 2018

Other details