Munini M, Fodor M, Corradi A, Frena A. Clinical benefits and controversies of jejunostomy feeding in patients undergoing gastrectomy for gastric cancer. World J Gastrointest Surg 2025; 17(3): 100384 [DOI: 10.4240/wjgs.v17.i3.100384]
Corresponding Author of This Article
Martino Munini, Surgeon, MD, Department of General and Pediatric Surgery, Bolzano Central Hospital, Via Lorenz Boehler nr. 5, Bolzano 39100, Trentino-Alto Adige, Italy. martino.munini@sabes.it
Research Domain of This Article
Surgery
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Mar 27, 2025; 17(3): 100384 Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.100384
Clinical benefits and controversies of jejunostomy feeding in patients undergoing gastrectomy for gastric cancer
Martino Munini, Margot Fodor, Alessio Corradi, Antonio Frena
Martino Munini, Margot Fodor, Alessio Corradi, Antonio Frena, Department of General and Pediatric Surgery, Bolzano Central Hospital, Bolzano 39100, Trentino-Alto Adige, Italy
Co-first authors: Martino Munini and Margot Fodor.
Author contributions: Frena A designed the overall concept of the manuscript and revised the manuscript; Fodor M contributed to writing and review of the manuscript; Corradi A and Munini M contributed to design, review of the literature and writing of the manuscript. All authors have read and approved the final manuscript.
Conflict-of-interest statement: No conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Martino Munini, Surgeon, MD, Department of General and Pediatric Surgery, Bolzano Central Hospital, Via Lorenz Boehler nr. 5, Bolzano 39100, Trentino-Alto Adige, Italy. martino.munini@sabes.it
Received: August 14, 2024 Revised: January 20, 2025 Accepted: February 8, 2025 Published online: March 27, 2025 Processing time: 193 Days and 10.8 Hours
Abstract
Globally, gastric cancer ranks as the fifth most common malignancy and the third leading cause of cancer-related mortality. Gastrectomy combined with perioperative chemotherapy is currently the standard of care in locally advanced stages, but the completion rate of multimodal approach is influenced also by patient related factors. Malnutrition is a well-known risk factor associated with poor oncological outcomes. Its perioperative supplementation could lead to an improvement of the nutritional status. This article reviews and comments the retrospective study conducted by Jaquet et al, which evaluates the impact of enteral nutrition by jejunostomy feeding in patients undergoing gastrectomy for cancer. The authors included 172 patients, 35% of whom received jejunostomy. Patients with optimized biological nutritional parameters (body mass index, albumin, prealbumin) showed reduced major complications (> III), according to the Dindo-Clavien classification, 0 (0%) vs 8 (4.7%) (P = 0.05). In the era of multimodal treatment, optimization of nutritional and performance status is integral part of the therapeutic strategy.
Core Tip: Malnutrition is a widely recognized risk factor linked to unfavorable oncological outcomes. Enteral nutrition has many advantages, including immune and intestinal mucosa support, avoidance of bacterial translocation, and decreased risk of venous catheter infection. With perioperative chemotherapy now established as the standard treatment for advanced gastric cancer, the discussion about the benefits of jejunostomy placement for nutritional support during diagnostic exploratory laparoscopy or major surgical procedures remains particularly pertinent.
