PP104 - A COMPARISON OF JEJUNOSTOMY TUBES IN LONG-TERM ENTERAL FEEDING: AN INTERRUPTED TIME SERIES AND HEALTH SERVICE UTILIZATION ANALYSIS

PP104

A COMPARISON OF JEJUNOSTOMY TUBES IN LONG-TERM ENTERAL FEEDING: AN INTERRUPTED TIME SERIES AND HEALTH SERVICE UTILIZATION ANALYSIS

A. O'Driscoll^1,2,*, J. Cronin³, E. Crowley¹, A. Lim⁴, S. Cushen⁵, T. Murphy^2,4

¹Human Nutrition and Dietetics, Mercy University Hospital, ²College of Medicine and Health, ³Cork University Business School, University College Cork, ⁴Department of Surgery, Mercy University Hospital, ⁵Food and Nutritional Sciences, University College Cork, Cork, Ireland

Rationale: Feeding jejunostomy (J-tube) is a well-established method in providing long-term enteral nutrition when oral and gastric routes are not accessible. However, catheter-related complications are frequent. We hypothesized that the AMT Capsule Monarch Gastrostomy tube adapted as a J-tube would have a lower complication profile compared to the Vygon J-tube in long-term enteral feeding.

Methods: Consecutive laparoscopic J-tubes placed over a 3 and a half-year period were reviewed. From July 2022 to June 2024 Vygon J-tubes were utilized and in July 2024 we switched to the Monarch J-tube for long-term enteral feeding. Monarch J-tube data was collected prospectively and compared to retrospectively collected data from the Vygon J-tube group using an interrupted time series analysis. Complications collected included (1) tube dislodgement, (2) tube malfunction, (3) skin infection requiring antibiotics and (4) stoma site complications. A health service utilization analysis was also performed.

Results: Seventy seven patients had a laparoscopic J-tube inserted: 47 Vygon and 30 Monarch J-tubes were placed. Tube dislodgements occurred more frequently in the Vvgon group compared to the Monarch group (21/47 vs 1/30; p< 0.001). Cellulitis occurred more frequently in the Vygon group compared to the Monarch group (11/47 vs 1/30; p=0.02). Tube malfunction rates were also higher in the Vygon group (10/47 v 0/30; p=0.0089). Stoma site complications were higher in the Monarch group (12/30 vs 4/47; p=0.004). Due to the requirement for tube reinsertions in the Vygon group (10/47 vs 0/30), using linear regression modelling, costs associated with the Vygon J-tube was 6 times higher than the Monarch J tube (p=0.004).

Conclusion: The AMT Capsule Monarch tube adapted to a J-tube has a lower complication profile and is more cost effective compared to the Vygon J-tube in long-term enteral feeding. 

Disclosure of Interest: None declared