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CRITICAL EVALUATION OF JEJUNOSTOMY

CRITICAL EVALUATION OF JEJUNOSTOMY Abstract THE RESTORATION and maintenance of an adequate nutritional status in patients unable to eat by mouth continue to be trying problems despite the emphasis that has been placed on the importance of nutrition in the surgical literature during recent years.1 Ordinarily in such situations intravenous administration of the required fluids is practiced, though this method has serious shortcomings when its use is necessary for more than a few days. These disadvantages include the danger of overloading the circulation in cardiac patients, prolonged periods of immobilization, and the difficulty of providing adequate amounts of calories and protein. In some situations feeding by means of a nasogastric tube has been attended by excellent results, and this method is particularly useful when a small caliber polyethylene tube is employed in conjunction with a force pump. However, this method in certain instances is impracticable because of such factors as mechanical obstruction to the References 1. Jones, C. M., and Eaton, F. B.: Postoperative Nutritional Edema , Arch. Surg. 27:159 ( (July) ) 1933.Crossref 2. Ravdin, I. S.; Stengel, A., Jr., and Prushankin, M.: The Control of Hypoproteinemia in Surgical Patients , J. A. M. A. 114:107 ( (Jan. 13) ) 1940. 3. Mulholland, J. H.; Tui, C.; Wright, A. M., and Vinci, V. J.: Nitrogen Metabolism, Caloric Intake and Weight Loss in Postoperative Convalescence , Ann. Surg. 117:512 ( (April) ) 1943.Crossref 4. Elman, R.: Acute Starvation Following Operation or Injury, with Special Reference to Caloric and Protein Needs , Mulholland Ann. Surg. 120:350 ( (Sept.) ) 1944.Crossref 5. Varco, R. L.: Preoperative Dietary Management for Surgical Patients , Surgery 19:303 ( (March) ) 1946. 6. Wolfer, J. A.: Jejunostomy with Jejunal Alimentation , Ann. Surg. 101:708 ( (Feb.) ) 1935.Crossref 7. Clute, H. M., and Bell, L. M.: Jejunostomy for Postoperative Feeding , Ann. Surg. 114:462 ( (Sept.) ) 1941.Crossref 8. Colp, R., and Druckerman, L. J.: The Indications for Jejunal Alimentation in the Surgery of Peptic Ulcer , Ann. Surg. 117:387 ( (March) ) 1943.Crossref 9. Rosenak, S., and Hollander, F.: Surgical Jejunostomy for Alimentation , Clinics 3:638 ( (Oct.) ) 1944. 10. Case, C. T.; Zollinger, R. M.; McMullen, C. H., and Brown, J. B.: Observations in Jejunal Alimentation , Surgery 26:364 ( (Sept.) ) 1949. 11. Scott, H. G., and Ivy, A. C.: Jejunal Alimentation , Ann. Surg. 93:1197 ( (June) ) 1931.Crossref 12. Hollander, F., and Sober, H. A.: A Modified Synthetic Predigested Aliment for Protracted Jejunostomy Feeding , Surgery 25:500 ( (April) ) 1949. 13. Poth, E.: Personal communication to the authors. 14. Dexin, brand of starch hydrolysate, manufactured by Burroughs Wellcome & Company, Inc., Tuckahoe, N. Y. 15. Protolysate, brand of protein hydrolysate, manufactured by Mead Johnson & Company, Evansville, Ind. 16. Randall, H. T.; Habif, D. V.; Lockwood, J. S., and Werner, S. C.: Potassium Deficiency in Surgical Patients , Surgery 26:341 ( (Sept.) ) 1949. 17. Stewart, J. D.; Hale, H. W., Jr., and Schaer, S. M.: Management of Protein Deficiency in Surgical Patients , J. A. M. A. 136:1017 ( (April) ) 1948.Crossref 18. Jones, C. M.; Culver, P. J.; Drummey, G. D., and Ryan, A. E.: Modification of Fat Absorption in the Digestive Tract by the Use of an Emulsifying Agent , Ann. Int. Med. 29:1 ( (July) ) 1948.Crossref 19. Lipomul-oral was supplied by the Upjohn Company, Kalamazoo, Mich. 20. Rosenak, S., and Hollander, F.: Early Postoperative Motor Response of the Small Intestine to Jejunal Feedings , S. Clin. North America 27:345 ( (April) ) 1947. 21. Allen, A. W., and Welch, C. E.: Jejunostomy for the Relief of Malfunctioning Gastroenterostomy Stoma , Surgery 9:163 ( (Feb.) ) 1941. 22. Walters, W., and Hartman, H. R.: Preoperative and Postoperative Care of Patients with Lesions of the Stomach and of the Duodenum , Arch. Surg. 40:1063 ( (June) ) 1940.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

CRITICAL EVALUATION OF JEJUNOSTOMY

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Publisher
American Medical Association
Copyright
Copyright © 1952 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1952.01260020372003
Publisher site
See Article on Publisher Site

Abstract

Abstract THE RESTORATION and maintenance of an adequate nutritional status in patients unable to eat by mouth continue to be trying problems despite the emphasis that has been placed on the importance of nutrition in the surgical literature during recent years.1 Ordinarily in such situations intravenous administration of the required fluids is practiced, though this method has serious shortcomings when its use is necessary for more than a few days. These disadvantages include the danger of overloading the circulation in cardiac patients, prolonged periods of immobilization, and the difficulty of providing adequate amounts of calories and protein. In some situations feeding by means of a nasogastric tube has been attended by excellent results, and this method is particularly useful when a small caliber polyethylene tube is employed in conjunction with a force pump. However, this method in certain instances is impracticable because of such factors as mechanical obstruction to the References 1. Jones, C. M., and Eaton, F. B.: Postoperative Nutritional Edema , Arch. Surg. 27:159 ( (July) ) 1933.Crossref 2. Ravdin, I. S.; Stengel, A., Jr., and Prushankin, M.: The Control of Hypoproteinemia in Surgical Patients , J. A. M. A. 114:107 ( (Jan. 13) ) 1940. 3. Mulholland, J. H.; Tui, C.; Wright, A. M., and Vinci, V. J.: Nitrogen Metabolism, Caloric Intake and Weight Loss in Postoperative Convalescence , Ann. Surg. 117:512 ( (April) ) 1943.Crossref 4. Elman, R.: Acute Starvation Following Operation or Injury, with Special Reference to Caloric and Protein Needs , Mulholland Ann. Surg. 120:350 ( (Sept.) ) 1944.Crossref 5. Varco, R. L.: Preoperative Dietary Management for Surgical Patients , Surgery 19:303 ( (March) ) 1946. 6. Wolfer, J. A.: Jejunostomy with Jejunal Alimentation , Ann. Surg. 101:708 ( (Feb.) ) 1935.Crossref 7. Clute, H. M., and Bell, L. M.: Jejunostomy for Postoperative Feeding , Ann. Surg. 114:462 ( (Sept.) ) 1941.Crossref 8. Colp, R., and Druckerman, L. J.: The Indications for Jejunal Alimentation in the Surgery of Peptic Ulcer , Ann. Surg. 117:387 ( (March) ) 1943.Crossref 9. Rosenak, S., and Hollander, F.: Surgical Jejunostomy for Alimentation , Clinics 3:638 ( (Oct.) ) 1944. 10. Case, C. T.; Zollinger, R. M.; McMullen, C. H., and Brown, J. B.: Observations in Jejunal Alimentation , Surgery 26:364 ( (Sept.) ) 1949. 11. Scott, H. G., and Ivy, A. C.: Jejunal Alimentation , Ann. Surg. 93:1197 ( (June) ) 1931.Crossref 12. Hollander, F., and Sober, H. A.: A Modified Synthetic Predigested Aliment for Protracted Jejunostomy Feeding , Surgery 25:500 ( (April) ) 1949. 13. Poth, E.: Personal communication to the authors. 14. Dexin, brand of starch hydrolysate, manufactured by Burroughs Wellcome & Company, Inc., Tuckahoe, N. Y. 15. Protolysate, brand of protein hydrolysate, manufactured by Mead Johnson & Company, Evansville, Ind. 16. Randall, H. T.; Habif, D. V.; Lockwood, J. S., and Werner, S. C.: Potassium Deficiency in Surgical Patients , Surgery 26:341 ( (Sept.) ) 1949. 17. Stewart, J. D.; Hale, H. W., Jr., and Schaer, S. M.: Management of Protein Deficiency in Surgical Patients , J. A. M. A. 136:1017 ( (April) ) 1948.Crossref 18. Jones, C. M.; Culver, P. J.; Drummey, G. D., and Ryan, A. E.: Modification of Fat Absorption in the Digestive Tract by the Use of an Emulsifying Agent , Ann. Int. Med. 29:1 ( (July) ) 1948.Crossref 19. Lipomul-oral was supplied by the Upjohn Company, Kalamazoo, Mich. 20. Rosenak, S., and Hollander, F.: Early Postoperative Motor Response of the Small Intestine to Jejunal Feedings , S. Clin. North America 27:345 ( (April) ) 1947. 21. Allen, A. W., and Welch, C. E.: Jejunostomy for the Relief of Malfunctioning Gastroenterostomy Stoma , Surgery 9:163 ( (Feb.) ) 1941. 22. Walters, W., and Hartman, H. R.: Preoperative and Postoperative Care of Patients with Lesions of the Stomach and of the Duodenum , Arch. Surg. 40:1063 ( (June) ) 1940.Crossref

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Sep 1, 1952

References