Early Enteral Nutrition Reduces the Rate of Life-Threatening Complications after Thoracic Esophagectomy in Patients with Esophageal Cancer

Abstract

Background: Early postoperative enteral nutrition has been suggested to improve the nutritional status of patients after esophageal surgery. However, whether enteral nutrition decreases rates of surgical complications and increases the completion rate of the clinical management pathway is unclear. Methods: We analyzed 154 patients who were randomly assigned to either an enteral or parenteral nutrition group after undergoing esophagectomy, compared the incidence of surgical complications, and evaluated the completion rate of the clinical pathway. In these 2 patient groups, perioperative management was performed through identical clinical pathways, except for nutrition. Results: The overall rate of surgical complications of any type did not differ between patients who received early enteral nutrition and those who did not (p = 0.50); however, the rate of life-threatening surgical complications was significantly lower in patients who received early enteral nutrition (p = 0.02). The rate of non-life-threatening surgical complications did not differ between the groups (p = 0.98). In patients who received enteral nutrition, the completion rate of the clinical pathway was higher (p = 0.03), and the postoperative hospital stay was shorter (p = 0.04). Conclusions: Early enteral nutrition reduces the incidence of life-threatening surgical complications and improves the completion rate of the clinical pathway for thoracic esophagectomy.

Nutrition in peri-operative esophageal cancer management

“…Following esophagectomy, early initiation of enteral nutrition is preferred over parenteral nutrition because it has been proven to reduce the number of life-threatening complications and length of hospital stay [78][79][80]. Enteral nutrition can be administered via tube feeding, by a surgically placed jejunostomy or a nasoduodenal or jejunal tube, or via oral intake.…”

Early Chest Tube Removal After Thoracoscopic Esophagectomy with High Output

“…20,21 In our department patients who underwent an esophagectomy were given enteral nutrition on POD 1, which made it easier for them to maintain the balance and made it possible to remove the chest tube early. 22 In order to obtain satisfactory results, we now routinely use the new volume threshold instead of traditional management for postoperative chest tube removal after TSE.…”

Society for Translational Medicine Expert Consensus on the prevention and treatment of postoperative pulmonary infection in esophageal cancer patients

“…Studies have shown that the use of enteral nutrition after surgery can effectively reduce the incidence of postoperative pulmonary infections (27,29). Earlier use is more effective at reducing the postoperative pulmonary infection incidence (30,31 In principle, enteral nutrition should be preferentially used for patients with a normal digestive tract. Parenteral nutrition supplements should be administered when enteral nutrition is insufficient.…”