{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:48:48Z","timestamp":1787071728726,"version":"build-2736575974"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Introduction:<\/jats:title>\n Patients with obstructive upper gastrointestinal malignancies often suffer from severe dysphagia and cachexia, necessitating enteral feeding. While open feeding jejunostomy (OFJ) is the traditional approach, laparoscopic feeding jejunostomy (LFJ) offers a minimally invasive alternative. This study aimed to compare the safety and outcomes of LFJ versus OFJ.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods:<\/jats:title>\n A prospective, randomised controlled trial was conducted at a tertiary care centre in South India from April 2022 to June 2023. Patients with obstructive upper gastrointestinal cancers were randomised to undergo LFJ or OFJ. The primary endpoint was the incidence of early major complications (Clavien\u2013Dindo grade \u22653). The secondary endpoints included operative time, intraoperative complications, post-operative pain, time to initiate and reach full-strength jejunal feeding, hospital stay and minor complications (Clavien\u2013Dindo grade \u22642). Patients were followed for 30 days postoperatively.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Fifty-nine patients met the inclusion criteria (30 LFJ, 29 OFJ). Baseline characteristics were similar, except for a higher rate of comorbidities in the OFJ group. The incidence of major complications was not significantly different (LFJ 10% vs. OFJ 17%,\n P<\/jats:italic>\n = 0.472). LFJ was associated with significantly fewer minor complications (26.6% vs. 89.6%,\n P<\/jats:italic>\n < 0.001), reduced post-operative pain, earlier initiation of feeds and shorter hospital stay. Operative time was longer in the LFJ group (100.4 \u00b1 12.5 vs. 59.2 \u00b1 6.9 min,\n P<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n LFJ is a safe and effective alternative to OFJ, offering better post-operative recovery despite a longer operative time and is recommended in appropriate candidates.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jmas.jmas_154_25","type":"journal-article","created":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T07:00:21Z","timestamp":1765004421000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of laparoscopic and open stand-alone feeding jejunostomy in patients with proximal gastrointestinal tract malignancies: An open-label randomised controlled trial"],"prefix":"10.4103","author":[{"given":"Srinath","family":"Rajasekar","sequence":"first","affiliation":[{"name":"Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uday Shamrao","family":"Kumbhar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chellappa","family":"Vijayakumar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. Abhinaya","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja","family":"Kalayarasan","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalaiarasi","family":"Raja","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"R1-20260324","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1177\/1756283X12467564","article-title":"Advantages of enteral nutrition over parenteral nutrition","volume":"6","author":"Seres","year":"2013","journal-title":"Therap Adv Gastroenterol"},{"key":"R2-20260324","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1038\/nrclinonc.2015.200","article-title":"Cachexia in patients with oesophageal cancer","volume":"13","author":"Anandavadivelan","year":"2016","journal-title":"Nat Rev Clin Oncol"},{"key":"R3-20260324","doi-asserted-by":"crossref","first-page":"9","DOI":"10.5005\/jp-journals-10001-1002","article-title":"Feeding tube enterostomies in upper aerodigestive tract cancers","volume":"1","author":"Saumitra","year":"2010","journal-title":"Int J Head Neck Surg"},{"key":"R4-20260324","doi-asserted-by":"crossref","first-page":"238","DOI":"10.5662\/wjm.v5.i4.238","article-title":"Laparoscopic surgery: A qualified systematic review","volume":"5","author":"Buia","year":"2015","journal-title":"World J Methodol"},{"key":"R5-20260324","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1007\/s00464-003-2187-7","article-title":"Laparoscopic feeding jejunostomy: A systematic review","volume":"19","author":"Han-Geurts","year":"2005","journal-title":"Surg Endosc"},{"key":"R6-20260324","doi-asserted-by":"crossref","first-page":"2485","DOI":"10.1007\/s00464-022-09782-x","article-title":"Laparoscopic versus open feeding jejunostomy: A systemic review and meta-analysis","volume":"37","author":"Hsiung","year":"2023","journal-title":"Surg Endosc"},{"key":"R7-20260324","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s12893-021-01050-4","article-title":"Purely laparoscopic feeding jejunostomy: A procedure which deserves more attention","volume":"21","author":"Tsai","year":"2021","journal-title":"BMC Surg"},{"key":"R8-20260324","first-page":"518","article-title":"Proposed classification of complications of surgery with examples of utility in cholecystectomy","volume":"111","author":"Clavien","year":"1992","journal-title":"Surgery"},{"key":"R10-20260324","doi-asserted-by":"crossref","first-page":"144","DOI":"10.6004\/jnccn.2020.7615","article-title":"Cachexia and dietetic interventions in patients with esophagogastric cancer: A multicenter cohort study","volume":"19","author":"Dijksterhuis","year":"2021","journal-title":"J Natl Compr Canc Netw"},{"key":"R11-20260324","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1080\/17474124.2017.1325320","article-title":"Nutrition in peri-operative esophageal cancer management","volume":"11","author":"Steenhagen","year":"2017","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"R12-20260324","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1053\/gast.2002.33587","article-title":"A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer","volume":"122","author":"Gianotti","year":"2002","journal-title":"Gastroenterology"},{"key":"R13-20260324","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1186\/s12893-021-01318-9","article-title":"Laparoscopic versus open feeding jejunostomy insertion in oesophagogastric cancer","volume":"21","author":"Mastoridis","year":"2021","journal-title":"BMC Surg"},{"key":"R14-20260324","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12893-017-0221-2","article-title":"Laparoscopic T-tube feeding jejunostomy as an adjunct to staging laparoscopy for upper gastrointestinal malignancies: The technique and review of outcomes","volume":"17","author":"Siow","year":"2017","journal-title":"BMC Surg"},{"key":"R15-20260324","doi-asserted-by":"crossref","first-page":"28","DOI":"10.7602\/jmis.2023.26.1.28","article-title":"Laparoscopic Witzel feeding jejunostomy: A procedure overlooked!","volume":"26","author":"Varshney","year":"2023","journal-title":"J Minim Invasive Surg"},{"key":"R16-20260324","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s11605-016-3297-6","article-title":"Complications of feeding jejunostomy tubes in patients with gastroesophageal cancer","volume":"21","author":"Choi","year":"2017","journal-title":"J Gastrointest Surg"},{"key":"R17-20260324","doi-asserted-by":"crossref","first-page":"3989","DOI":"10.1007\/s00464-020-07787-y","article-title":"Complications of feeding jejunostomy placement: A single-institution experience","volume":"35","author":"Okida","year":"2021","journal-title":"Surg Endosc"}],"container-title":["Journal of Minimal Access Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_154_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:52:39Z","timestamp":1787068359000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_154_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,5]]},"references-count":16,"URL":"https:\/\/doi.org\/10.4103\/jmas.jmas_154_25","relation":{},"ISSN":["0972-9941","1998-3921"],"issn-type":[{"value":"0972-9941","type":"print"},{"value":"1998-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,5]]},"assertion":[{"value":"2025-04-19","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-20","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}