Early oral intake and early removal of nasogastric tube post‐esophagectomy: A systematic review and meta‐analysis

Kaaki, Suha; Grigor, Emma; Maziak, Donna E.; Seely, Andrew J. E.

doi:10.1002/cnr2.1538

Cited by 6 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A meta-analysis by Weijs et al [ 13 ] reported similar results that hospital stay was significantly shorter with preoperative or early removal of NGT. However, a recent meta-analysis of six RCTs by Kaaki et al [ 18 ] found that early removal of NGT has no impact on length of stay (LOS), whereas early oral intake found shorter LOS. Hence, it is apparent that early oral feeding (EOF) can be initiated easily in the no NGT group to receive its benefit.…”

Section: Discussionmentioning

confidence: 99%

Impact of nasogastric tube exclusion after minimally invasive esophagectomy for esophageal cancer: a single-center retrospective study in India

Varshney,

et al. 2024

J Minim Invasive Surg

View full text Add to dashboard Cite

Purpose This study examines the impacts of omitting nasogastric tube (NGT) placement following cervical esophagogastric anastomosis (CEGA) in Enhanced Recovery After Surgery (ERAS) protocols, comparing outcomes to those from early NGT removal. Methods In a retrospective cohort of esophagectomy patients treated for esophageal cancer, participants were divided into two groups group 1 had the NGT inserted post-CEGA and removed by postoperative day 3, while group 2 underwent the procedure without NGT placement. We primarily investigated anastomotic leak rates, also analyzing hospital stay duration, pulmonary complications, and NGT reinsertion. Results Among 50 esophageal squamous cell carcinoma patients, 30 in group I were compared with 20 in group II. The baseline demographic and tumor characteristics were similar between both groups. The overall incidence of anastomotic leak was 14.0%, comparable in both groups (16.7% vs. 10.0%, p = 0.63). The postoperative hospital stay was significantly shorter in the no NGT group (median of 7 days vs. 6 days, p = 0.03) with similar major morbidity (Clavien-Dindo grade ≥IIIa; 13.3% vs. 5.0%, p = 0.63). There was no 30-day mortality, and one patient in each group had reinsertion of NGT for conduit dilatation. Conclusion The exclusion of an NGT across CEGA after esophagectomy did not influence the anastomotic leak rate with comparable complications and a shorter hospital stay.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of nasogastric tube exclusion after minimally invasive esophagectomy for esophageal cancer: a single-center retrospective study in India

Varshney,

et al. 2024

J Minim Invasive Surg

View full text Add to dashboard Cite

show abstract

“… 24 – 27 Also, early NGT removal does not seem to increase the risk of anastomotic leakage, as multiple meta-analyses evaluating early removal or even omission of the NGT have found no differences in anastomotic leakage rates. 6 , 28 …”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Radiologic Evaluation of Gastric Conduit Emptying After Esophagectomy

et al. 2022

View full text Add to dashboard Cite

Background Nasogastric tube (NGT) insertion is the standard of care in many hospitals after esophagectomy for gastric conduit decompression. An upper gastrointestinal contrast passage evaluation (UGI-CE) is a diagnostic test to evaluate passage through the gastric conduit. The authors hypothesized that introducing routine UGI-CE after esophagectomy results in earlier removal of the NGT and resumption of oral intake. Methods This retrospective study evaluated two consecutive series of patients undergoing esophagectomy, one before (control group) and one after the introduction of a routine UGI-CE on postoperative day (POD) 3 or 4 (UGI-CE group). If contrast passage was found on the UGI-CE, the NGT was capped and removed. In the control group, the NGT was routinely capped and removed on day 5 after surgery. The primary outcome was the POD on which oral diet was initiated. The secondary outcomes were the day of NGT removal, NGT reinsertions, postoperative complications, and length of hospital stay. Results Each cohort included 74 patients. In the UGI-CE group, the contrast test was performed on median POD 3.5 (IQR, 3–4). The median day of NGT removal, initiation of clear liquids, and full liquid and solid intake was 1 to 2 days earlier in the UGI-CE group than in the control group (i.e. POD 4, 4, 5, and 6 vs. POD 5, 5, 6.5, and 8; all p < 0.001). The study found no significant differences in NGT reinsertions, pneumonias, anastomotic leakages, or hospital stay. Conclusion The routine use of a UGI-CE after esophagectomy led to earlier removal of the NGT and earlier resumption of oral intake.

show abstract

“…With the development of fast track surgery and enhanced recovery after surgery (ERAS) programmes,6 there has been an increasing trend towards improved quality of life (QOL) following operation. Early oral intake (EOI), as one of the fundamental programmes in ERAS, has been confirmed as a safe and feasible procedure that improved clinical outcomes including faster recovery of bowel function in the perioperative care of gastrointestinal surgery, oesophagectomy and gynaecological surgery 7–9. Meanwhile, studies on these topics have also shown that EOI could shorten the length of hospital stay by 1.7 days and did not increase the occurrence of adverse complications 10.…”

Section: Introductionmentioning

confidence: 99%

“…Early oral intake (EOI), as one of the fundamental programmes in ERAS, has been confirmed as a safe and feasible procedure that improved clinical outcomes including faster recovery of bowel function in the perioperative care of gastrointestinal surgery, oesophagectomy and gynaecological surgery. [7][8][9] Meanwhile, studies on…”

Section: Introduction Background and Rationalementioning

confidence: 99%

Effect of modified endotracheal intubation protocol combined with early oral intake on postoperative recovery quality in thyroid and parathyroid surgery at a tertiary hospital in China: a 2x2 factorial randomised controlled trial protocol

Wu,

Zhang,

Shen

2024

BMJ Open

View full text Add to dashboard Cite

IntroductionEarly oral intake (EOI) is supposed to be safe and beneficial to patients’ recovery. However, the optimal timing of resuming oral intake has not been validated in thyroid and parathyroid surgery. On the other hand, a modified electromyography (EMG) endotracheal intubation protocol with real-time EMG monitoring during video laryngoscope/fibrescope-guided intubation was presented in 2022, which was regarded as an effective way to shorten the intubation time. We aimed to use Quality of Recovery-15 (QoR-15) questionnaire to compare the efficacy and safety of different EMG endotracheal intubation protocols combined with different postoperative oral intake strategy in thyroid and parathyroid surgery.Methods and analysisThis prospective, single-centre, 2×2 factorial, randomised controlled trial will be conducted in the Peking Union Medical College Hospital (PUMCH), China. We plan to recruit 200 adult patients who will receive thyroid or parathyroid surgery under intraoperative nerve monitoring. Eligible patients will be randomly divided into two groups, which will receive either the modified intubation protocol (M group) or conventional intubation process (C group). After patients enter postanaesthesia care unit and Steward scores ≥4, they will be randomly divided into two groups again, which will receive early resumption of oral intake (E group) or delayed resumption of oral intake (D group). Patients will be followed up during hospitalisation and the QoR-15 questionnaire will be administered to compare the quality of recovery on the day before surgery (T0), the first day after surgery (T1) and the day of discharge (T2). The primary outcome is the QoR-15 scores at T1.Ethics and disseminationThe study protocol has been approved by the Research Ethics Committee of Peking Union Medical College Hospital (IRB K-2501). All participants will give written informed consent before participation. The results from this study will be shared at conferences and disseminated in international journals.Trial registration numberNCT05624463.

show abstract

Early oral intake and early removal of nasogastric tube post‐esophagectomy: A systematic review and meta‐analysis

Cited by 6 publications

References 17 publications

Impact of nasogastric tube exclusion after minimally invasive esophagectomy for esophageal cancer: a single-center retrospective study in India

Impact of nasogastric tube exclusion after minimally invasive esophagectomy for esophageal cancer: a single-center retrospective study in India

Contrast-Enhanced Radiologic Evaluation of Gastric Conduit Emptying After Esophagectomy

Effect of modified endotracheal intubation protocol combined with early oral intake on postoperative recovery quality in thyroid and parathyroid surgery at a tertiary hospital in China: a 2x2 factorial randomised controlled trial protocol

Contact Info

Product

Resources

About