Safety and feasibility of jejunostomy on elderly patients undergoing minimally invasive esophagectomy

Early postoperative enteral nutrition via jejunostomy tube is recommended for patients undergoing esophagectomy, especially for elderly patients. However, there are limited research on the safety of routine intraoperative jejunostomy in elderly patients undergoing minimally invasive esophagectomy (MIE). This study analyzes the safety and feasibility of intraoperative jejunostomy in elderly patients undergoing (MIE) to provide a reference for clinical practice. A retrospective analysis was performed with 143 patients aged over 70 years who underwent MIE with intraoperative jejunostomy from January 2021 to December 2023. Among them, 73 patients with a mean age of 71.9 (age range: 70–74) years in Group A and 70 patients with a mean age of 78.5 (age range: 75–93) years in Group B. The preoperative clinical characteristics, surgical approaches, postoperative complications, jejunostomy tube-related complications, and enteral nutrition-related clinical features were analyzed. Patients in Group B had a statistically significant lower BMI compared to Group A, the Length of ICU stay in Group B was longer than Group A and the incidence of chyle leakage was higher in Group B, the differences were statistically significant. The two groups were similar in terms of tube-related complications, with no significant statistical difference. Regarding the comparison of enteral nutrition-related clinical features, Group A had a longer duration on parenteral nutrition time and delayed first defecation after surgery. However, for hospital stay after surgery, duration of home enteral nutrition, and duration of jejunostomy tube placement after discharge, Group B had longer durations than that in Group A, and the differences were statistically significant. Intraoperative jejunostomy has been confirmed to be a safe and feasible procedure in elderly patients undergoing MIE. Furthermore, for patients aged 75 and above, the jejunostomy tube offers a reliable and sufficient route for postoperative enteral nutrition support during prolonged hospital stays.