Type of Surgery
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Last updated: 02/17/2009
A number of conditions necessitate tube enterostomy for nutritional support. Many are chronic and require a complete medical evaluation including history, physical examination, and extensive imaging tests. Some conditions are critical or acute,...
and may emerge from injuries or serious inflammatory conditions in which the patient is not systematically prepared for the surgery. In many cases, the patient undergoing this type of surgery has been ill for a period of time. Sometimes the patient is a small child or adult who accidentally swallowed a caustic substance. Some are elderly patients who have obstructive carcinoma of the esophagus or stomach.
Optimal preparation includes an evaluation of the patient's nutritional status, and his or her potential requirement for blood transfusions and antibiotics. Patients who do not have gastrointestinal inflammatory or obstructive conditions are usually required to undergo bowel preparation that flushes the intestines of all material. The bowel preparation reduces the chances of infection.
The patient's acceptance of tube feeding as a substitute for eating is of paramount importance. Health care providers must be sensitive to these problems, and offer early assistance and feedback in the self-care that the tube enterostomy requires.
In preparation for surgery, patients learn that the tube enterostomy will be an artificial orifice placed outside the abdomen through which they will deliver their nutritional support. Patients are taught how to care for the stoma, cleaning and making sure it functions optimally. In addition, patients are prepared for the loss of the function of eating and its place in their lives. They must be made aware that their physical body will be altered, and that this may have social implications and affect their intimate activities.
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Tube enterostomy, or tube feeding, is a form of enteral or intestinal site feeding that employs a stoma or semi-permanent surgically placed tube to the small intestines.
Many patients are unable to take in food by mouth, esophagus, or stomach. A number of conditions can render a person unable to take in nutrition through the normal pathways. Neurological conditions or injuries, injuries to the mouth or throat, obstructions of the stomach, cancer or ulcerative conditions of the gastrointestinal tract, and certain surgical procedures can make it impossible for a person to receive oral nutrition. Tube feeding is indicated for patients unable to ingest adequate nutrition by mouth, but who may have a cleared passage in the esophagus and stomach, and even partial functioning of gastrointestinal tract. Enteral nutrition procedures that utilize the gastrointestinal tract are preferred over intravenous feeding or parenteral nutrition because they maintain the function of the intestines, provide for immunity to infection, and avoid complications related to intravenous feeding.
Tube enterostomy, a feeding tube placed directly into the intestines or jejunum, is one such enteral procedure. It is used if the need for enteral feeding lasts longer than six weeks, or if it improves the outcomes of drastic surgeries such as removal or resection of the intestines. Recently, it has become an important technique for use in surgery in which a gastroectomy—resection of the intestinal link to the esophagus—occurs. The procedure makes healing easier, and seeks to retain the patient's nutritional status and quality of life after reconstructive surgery. Some individuals have a tube enterostomy surgically constructed, and successfully utilize it for a long period of time.
From http://www.surgeryencyclopedia.com/St-Wr/Tube-Enterostomy.html
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