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Evaluation of laparoscopic-assisted placement of jejunostomy feeding tubes in dogs

Saundra A. HewittDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1 Canada.

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Brigitte A. BrissonDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1 Canada.

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Melissa D. SinclairDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1 Canada.

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Robert A. FosterDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1 Canada.

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Seanna-Lynn SwayneDepartment of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1 Canada.

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Abstract

Objective—To evaluate feasibility of performing laparoscopic-assisted placement of a jejunostomy feeding tube (J-tube) and compare complications associated with placement, short-term feedings, and medium-term healing with surgically placed tubes in dogs.

Design—Prospective study.

Animals—15 healthy mixed-breed dogs.

Procedure—Dogs were randomly allocated to undergo open surgical or laparoscopic-assisted J-tube placement. Required nutrients were administered by a combination of enteric and oral feeding while monitoring for complications. Radiographic contrast studies documented tube direction and location, altered motility, or evidence of stricture.

Results—Jejunostomy tubes were successfully placed in the correct location and direction in all dogs. In the laparoscopic group, the ileum was initially selected in 2 dogs, 2 dogs developed moderate hemorrhage at a portal site, and 2 J-tubes kinked during placement but were successfully readjusted postoperatively. All dogs tolerated postoperative feedings. All dogs developed minor ostomy site inflammation, and 1 dog developed bile-induced dermatitis at the ostomy site. Despite mild, transient neutrophilia, no significant difference was noted in WBC counts between groups. No dog had altered gastric motility or evidence of stricture, although the jejunopexy site remained identifiable in several dogs at 30 days.

Conclusions and Clinical Relevance—Requirements for successful J-tube placement were met by use of a laparoscopic-assisted technique, and postoperative complications were mild and comparable to those seen with surgical placement. Laparoscopic-assisted J-tube placement compares favorably to surgical placement in healthy dogs and should be considered as an option for dogs requiring enterostomy feeding but not requiring a celiotomy for other reasons. (J Am Vet Med Assoc 2004;225:65–71)

Abstract

Objective—To evaluate feasibility of performing laparoscopic-assisted placement of a jejunostomy feeding tube (J-tube) and compare complications associated with placement, short-term feedings, and medium-term healing with surgically placed tubes in dogs.

Design—Prospective study.

Animals—15 healthy mixed-breed dogs.

Procedure—Dogs were randomly allocated to undergo open surgical or laparoscopic-assisted J-tube placement. Required nutrients were administered by a combination of enteric and oral feeding while monitoring for complications. Radiographic contrast studies documented tube direction and location, altered motility, or evidence of stricture.

Results—Jejunostomy tubes were successfully placed in the correct location and direction in all dogs. In the laparoscopic group, the ileum was initially selected in 2 dogs, 2 dogs developed moderate hemorrhage at a portal site, and 2 J-tubes kinked during placement but were successfully readjusted postoperatively. All dogs tolerated postoperative feedings. All dogs developed minor ostomy site inflammation, and 1 dog developed bile-induced dermatitis at the ostomy site. Despite mild, transient neutrophilia, no significant difference was noted in WBC counts between groups. No dog had altered gastric motility or evidence of stricture, although the jejunopexy site remained identifiable in several dogs at 30 days.

Conclusions and Clinical Relevance—Requirements for successful J-tube placement were met by use of a laparoscopic-assisted technique, and postoperative complications were mild and comparable to those seen with surgical placement. Laparoscopic-assisted J-tube placement compares favorably to surgical placement in healthy dogs and should be considered as an option for dogs requiring enterostomy feeding but not requiring a celiotomy for other reasons. (J Am Vet Med Assoc 2004;225:65–71)