Early oral feeding following thoracolaparoscopic oesophagectomy for oesophageal cancer

Sun, Haibo; Liu, Xianben; Zhang, Rui-Xiang; Wang, Zongfei; Qin, Jianjun; Yan, Ming; Liu, Baoxing; Wei, Xiufeng; Leng, Cathryn; Zhu, Junwei; Yu, Yonghao; Li, Haomiao; Zhang, Jun; Li, Yin

doi:10.1093/ejcts/ezu168

Cited by 61 publications

(94 citation statements)

References 20 publications

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“…Rather, the earlier reintroduction of oral or enteral fluids was associated with a reduced length of hospital stay, with a combined mean length of hospital stay of 19±5 vs 25±18 days (mean ± standard deviation [SD]). [15][16][17] The overall complication rates were similar between the two groups (40% vs 45%). The three studies that measured duration of postoperative ileus time found that earlier reintroduction of oral or enteral intake reduced duration of ileus from a mean of 7 days (SD 2) to a mean of 5 days (SD 1).…”

Section: Early Challenges Interruption Of Oral Dietmentioning

confidence: 73%

“…Table 2 summarizes the four cohort studies that evaluated optimal timing of reestablishing oral or enteral fluid intake. [15][16][17][18] The earlier reintroduction of oral or enteral fluid had no deleterious effects on clinical outcome, specifically anastomotic leak. Rather, the earlier reintroduction of oral or enteral fluids was associated with a reduced length of hospital stay, with a combined mean length of hospital stay of 19±5 vs 25±18 days (mean ± standard deviation [SD]).…”

Section: Early Challenges Interruption Of Oral Dietmentioning

confidence: 91%

“…The three studies that measured duration of postoperative ileus time found that earlier reintroduction of oral or enteral intake reduced duration of ileus from a mean of 7 days (SD 2) to a mean of 5 days (SD 1). [15][16][17] It should be highlighted that in common with most studies, resumption of eating did not occur until the seventh day, irrespective of when fluids were permitted.…”

Section: Early Challenges Interruption Of Oral Dietmentioning

confidence: 96%

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Nutritional support and dietary interventions following esophagectomy: challenges and solutions

Paul¹,

Baker²,

Williams³

et al. 2017

NDS

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Background and aims: Provision of adequate nutrition after esophagectomy remains a major challenge. The aims of this review were to describe the challenges facing this patient population and to determine the evidence base underpinning current nutritional and dietetic interventions after esophagectomy. Methods: Medline, Embase and CINAHL databases were searched for English language publications of the period 1990-2016 reporting on the outcome of nutritional or dietetic interventions after esophagectomy or patient-related symptoms. Results: Four studies demonstrated that early reintroduction of oral fluids was safe and was associated with a shorter hospital stay and ileus duration. One of three studies comparing in-hospital enteral nutrition against usual care showed that enteral feeding was well tolerated and was associated with a shorter hospital stay. Eight studies comparing enteral with parenteral nutrition showed similar surgical complication rates. Enteral feeding was associated with a shorter duration of ileus and lower health care costs. In hospital, all types of enteral access (nasoenteral, jejunostomy) were equivalent in their safety profiles. Cohort studies indicate that technical (tube dysfunction) and feed (diarrhea, distention) problems were common with jejunostomies but are easily managed. The mortality risk associated with jejunostomy in hospital is 0.2% (reported range 0%-1%), principally due to small bowel ischemia. There have been no reports of serious jejunostomy complications in patients receiving home feeding. One study demonstrated the advantages of home feeding in weight, muscle and fat preservation. Studies reporting 12 months or more after esophagectomy indicate a high frequency of persistent symptoms, dumping syndrome 15%-75% (median 46%), dysphagia 11%-38% (median 27%), early satiety 40%-90% (median 65%) and reflux 19%-61% (median 29%). Conclusion: Patients should resume oral intake as soon as possible after surgery. In hospital, all forms of enteral access appear to be safe. Out of hospital, the ability to provide home feeding by feeding jejunostomy is likely where meaningful nutritional improvements can be made. Improving nutrition and related quality of life in the early months might improve the long-term outcome.

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Section: Early Challenges Interruption Of Oral Dietmentioning

confidence: 73%

Section: Early Challenges Interruption Of Oral Dietmentioning

confidence: 91%

Section: Early Challenges Interruption Of Oral Dietmentioning

confidence: 96%

See 1 more Smart Citation

Nutritional support and dietary interventions following esophagectomy: challenges and solutions

Paul¹,

Baker²,

Williams³

et al. 2017

NDS

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show abstract

“…Moreover, the gastric emptying for liquid food after esophagectomy was significantly faster in the early oral feeding group (1).…”

mentioning

confidence: 91%

The first randomized controlled trial on early versus late oral feeding after minimally invasive esophagectomy and the ongoing quest for more evidence

Cuesta¹

2017

J. Thorac. Dis.

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“…Advancements in technology and techniques have affected every surgical field, and it is our hope that these further advancements should spread to other fields as well. For example, laparoscopic, urologic, cardiac, hepatobiliary, and hepatic surgical fields may also be able to reduce the use of a gastric or drainage tube to a patient's benefit (11). However, the indications and contraindications for each tube in each field still require extensive investigation.…”

mentioning

confidence: 99%

Simple to simplest: the tubeless technique

Liu

Hamblin

et al. 2017

J Thorac Dis

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Early oral feeding following thoracolaparoscopic oesophagectomy for oesophageal cancer

Abstract: Compared with preoperative gastric emptying, early postoperative gastric emptying for liquid food after oesophagectomy is significantly faster. Postoperative early oral feeding in patients with thoracolaparoscopic oesophagectomy is feasible and safe.

Cited by 61 publications

References 20 publications

Nutritional support and dietary interventions following esophagectomy: challenges and solutions

Nutritional support and dietary interventions following esophagectomy: challenges and solutions

The first randomized controlled trial on early versus late oral feeding after minimally invasive esophagectomy and the ongoing quest for more evidence

Simple to simplest: the tubeless technique

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