Chewing 50 times per bite could help to resume oral feeding on the first postoperative day following minimally invasive oesophagectomy

Zhu, Zhengshuai; Yin, Li; Zheng, Yan; Sun, Haibo; Liu, Xianben; Zhang, Ruixiang; Wang, Zongfei; Liu, Shilei; Chen, Xiankai; Hua, Xionghuai; Yu, Yonghao; Li, Haomiao; Zhang, Jun; Liu, Qi

doi:10.1093/ejcts/ezx291

Cited by 19 publications

(20 citation statements)

References 17 publications

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“…Furthermore, several studies have addressed the topic of efficacious postoperative direct oral feeding as part of the “enhanced recovery after surgery (ERAS) protocol [16]”. Several studies have reported that patients undergoing surgery for esophageal cancer resumed oral feeding at postoperative meal start [postoperative day (POD) 1] [17,18], and the importance of oral intake is increasing. In the present study, we enrolled patients between June 2009 and December 2010, and some differences existed due to the current trends of nutritional support.…”

Section: Introductionmentioning

confidence: 99%

Effect of Postoperative Oral Intake on Prognosis for Esophageal Cancer

et al. 2019

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Background: Patients undergoing surgery for esophageal cancer are at risk of prolonged hospital stay for postoperative malnutrition. Postoperative early oral feeing is a part of the “enhanced recovery after surgery protocol” for coping with this risk. However, the usefulness of early oral intake during perioperatively is questionable. Methods: In total, 117 patients treated surgically for esophageal cancer were analyzed in the study. We assessed the oral energy sufficiency rate per nutritional requirement (oral-E/NR) at the fourth week postoperatively and classified the patients into two groups: Poor oral intake group (POI group; <25% oral-E/NR) and the control group (≥25% oral-E/NR). We analyzed the relationship among postoperative oral intake and prognoses. Results: The POI group had worse postoperative nutritional status and a lower survival rate than the control group. In a multivariate analysis, <25% oral-E/NR was one of the independent factors contributing to negative outcomes postoperatively (adjusted hazard ratio: 2.70, 95% confidence interval: 1.30–5.61). Conclusions: In patients undergoing surgery for esophageal cancer, poor postoperative oral intake negatively affected not only on their postoperative nutritional status but also their overall prognosis. It is necessary to improve the adequacy of oral intake postoperatively for patients with esophageal cancer.

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Section: Introductionmentioning

confidence: 99%

Effect of Postoperative Oral Intake on Prognosis for Esophageal Cancer

et al. 2019

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“…All operations were performed by one surgical team led by one author. The “non‐tube no fasting” fast‐track program was the first choice for all patients, except when symptoms of aspiration or the appearance of serious complications arose, at which time oral feeding was delayed or ceased . Normally the nutrition provided by intravenous approach decreases with the increase in oral feeding, and is removed on the fourth day after surgery.…”

Section: Methodsmentioning

confidence: 99%

“…The "non-tube no fasting" fast-track program was the first choice for all patients, except when symptoms of aspiration or the appearance of serious complications arose, at which time oral feeding was delayed or ceased. 15,17 Normally the nutrition provided by intravenous approach decreases with the increase in oral feeding, and is removed on the fourth day after surgery. The need for adjuvant therapy after surgery is determined by the pathology stage and the patients' aspiration and nutrition status.…”

Section: Surgery and Recoverymentioning

confidence: 99%

Analysis of the associated factors for severe weight loss after minimally invasive McKeown esophagectomy

Wang

Sun

et al. 2018

Thoracic Cancer

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BackgroundThis study investigated the risk factors for severe weight loss (SWL) within one year after minimally invasive McKeown esophagectomy.MethodsEsophageal cancer patients who underwent McKeown esophagectomy between January and July 2017 were prospectively enrolled. Preoperative body weight (PBW) was chosen as the initial body weight.ResultsForty‐four patients were enrolled and successfully followed up for one year. Median weight loss was 7.4% (quartile: 5.3–8.1%) and 12.6% (quartile: 8.8–17.7%) four weeks and one year after surgery, respectively. Accelerated weight loss occurred during the first two weeks after discharge, with median weight loss of 5.6% (quartile: 4.2–7.1%). Multivariable analysis showed that age ≥ 70 years (odds ratio [OR] 7.65; P = 0.030), preoperative sarcopenia (OR 7.18; P = 0.030), the first surgery in the daily schedule (OR 6.87; P = 0.032) and vocal cord paralysis (OR 12.30; P = 0.046) were independent risk factors for short‐term (4 weeks) SWL (> 7.5% PBW), while an American Society of Anesthesiologists score of 3–4 (OR 6.58; P = 0.047), a high fat‐free mass (OR 21.91; P = 0.003), and vocal cord paralysis (OR 25.83; P = 0.017) were independent risk factors for long‐term (1 year) SWL (> 13.0% PBW) after esophagectomy. Postoperative symptoms of insomnia, appetite loss, dysphagia, eating difficulties, and taste issues were also related to SWL.ConclusionsIn esophageal cancer patients who have undergone esophagectomy, the first two weeks after hospital discharge is a key period for nutrition intervention. Patients with associated factors for SWL require postoperative nutrition support.

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“…At POD 2, semi-liquid foods and soft solid foods such as cakes, noodles, rice, eggs and steamed bread were provided. All patients were encouraged to chew carefully and completely when eating soft solid food [7]. In the event of aspiration, severe distension, or signs of leakage, oral intake was halted.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Impact of an Early Oral Feeding Protocol on Inflammatory Cytokine Changes After Esophagectomy

Sun

Liu

et al. 2019

The Annals of Thoracic Surgery

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Background: The aim of the current study was to investigate the impact of early oral feeding (EOF) on inflammatory cytokine levels after McKeown minimally invasive esophagectomy (MIE) for cancer Methods: This study was based on a randomized controlled trial (NCT01998230). Patients with esophageal cancer who received McKeown MIE were randomly allocated into a group that started oral feeding on postoperative day (POD) 1 (EOF group) or a second group that received nil by mouth until 7 days after surgery (late oral feeding, LOF group). We chose 86 patients, including 46 patients in the EOF group and 40 patients in the LOF group, in which to analyze inflammatory cytokine levels (interleukin-6, IL-6; interleukin-8, IL-8; tumor necrosis factor-a, TNF-α; and monocyte chemotactic protein-1, MCP-1).

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Chewing 50 times per bite could help to resume oral feeding on the first postoperative day following minimally invasive oesophagectomy

Cited by 19 publications

References 17 publications

Effect of Postoperative Oral Intake on Prognosis for Esophageal Cancer

Effect of Postoperative Oral Intake on Prognosis for Esophageal Cancer

Analysis of the associated factors for severe weight loss after minimally invasive McKeown esophagectomy

Impact of an Early Oral Feeding Protocol on Inflammatory Cytokine Changes After Esophagectomy

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