Nutritional access routes following oesophagectomy—a systematic review

Markides, G A; Alkhaffaf, Bilal; Vickers, J

doi:10.1038/ejcn.2010.292

Cited by 35 publications

(23 citation statements)

References 26 publications

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“…Patients with esophageal cancer tend to have varying degrees of malnutrition because of the reduced food intake as a result of dysphagia, preoperative diet restrictions, and nutrition consumption by tumors . Furthermore, the preoperative nutritional status of patients undergoing major surgery has been shown partially impact on postoperative rehabilitation, and malnutrition is associated with increased morbidity and mortality in hospitalized patients . Thus, for the patients with esophageal cancer, the poor preoperative nutritional status may increase the risk of postoperative complications .…”

Section: Introductionmentioning

confidence: 99%

Early enteral nutrition compared with parenteral nutrition for esophageal cancer patients after esophagectomy: a meta-analysis

Peng

Cai

et al. 2015

Dis Esophagus

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Early postoperative enteral nutrition (EN) after esophagectomy in esophageal cancer patient has been reported to be correlated with a better rehabilitation than parenteral nutrition (PN). However, a robust conclusion has not been achieved. Therefore, we performed a meta-analysis to compare the postoperative EN and PN in patients with esophageal cancer undergoing esophagectomy. Three electronic databases were searched for eligible studies to be included in the meta-analysis. The summary relative risk/weighted mean difference (RR/WMD) estimates and corresponding 95% confidence interval (CI) were calculated using fixed- and random-effects models. Ten studies met the inclusion criteria. The analysis demonstrated that the early postoperative EN could significantly decrease the pulmonary complications (RR = 0.37, 95% CI = 0.22-0.62, P = 0.00, test for heterogeneity: I(2) = 0.0%, P = 0.89) and anastomotic leakage (RR = 0.46, 95% CI = 0.22-0.96, P = 0.04, test for heterogeneity: I(2) = 0.0%, P = 0.66) compared with PN. On the eighth postoperative day, the EN group had a higher levels of albumin (WMD = 1.84, 95% CI = 0.47-3.21, P = 0.01, test for heterogeneity: I(2) = 84.5%, P = 0.00) and prealbumin (WMD = 12.96, 95% CI = 3.63-22.29, P = 0.01, test for heterogeneity: I(2) = 0.0%, P = 0.63) compared with the PN group. However, there was no difference in digestive complications between these two approaches (RR = 1.30, 95% CI = 0.79-2.13, P = 0.30, test for heterogeneity: I(2) = 0.0%, P = 0.97). For patients with esophageal cancer following esophagectomy, the early postoperative EN support could decrease the morbidity of severe complications, such as pulmonary complications and anastomotic leakage, and maintain patients at a better nutritional status than parenteral nutrion support.

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Section: Introductionmentioning

confidence: 99%

Early enteral nutrition compared with parenteral nutrition for esophageal cancer patients after esophagectomy: a meta-analysis

Peng

Cai

et al. 2015

Dis Esophagus

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“…Da nasojejunale und nasoduodenale Sonden signifikant häufiger und früher dislozieren [374,375] ist die FKJ der nasojejunalen oder -duodenalen Sonde zur längerfristigen enteralen Ernährung überlegen [375].…”

Section: Hintergrundunclassified

S3-Leitlinie – Diagnostik und Therapie der Plattenepithelkarzinome und Adenokarzinome des Ösophagus

et al. 2019

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“…During the first postoperative days patients are regularly kept nil-by-mouth, and often complications or gastro-intestinal dysfunction impair oral intake (1)(2)(3).These problems may prolong the hospital admission time, result in a re-admission and cause extensive weight loss. Even at a long-term, a decreased caloric intake and persistent weight loss are evident in this patient group (4,5).…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand a jejunostomy is considered to be comfortable and effective for long-term nutritional support (2,6). Furthermore routine discharge with home-tube feeding has been advocated recently, which is facilitated by routine creation of a jejunostomy (7).…”

Section: Introductionmentioning

confidence: 99%

Routine jejunostomy tube feeding following esophagectomy

Weijs¹,

Eden²,

Ruurda³

et al. 2017

J. Thorac. Dis.

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Background: Malnutrition is an important problem following esophagectomy. A surgically placed jejunostomy secures an enteral feeding route, facilitating discharge with home-tube feeding and long-term nutritional support. However, specific complications occur, and data are lacking that support its use over other enteral feeding routes. Therefore routine jejunostomy tube feeding and discharge with home-tube feeding was evaluated, with emphasis on weight loss, length of stay and re-admissions.Methods: Consecutive patients undergoing esophagectomy for cancer, with gastric tube reconstruction and jejunostomy creation, were analyzed. Two different regimens were compared. Before January 07, 2011 patients were discharged when oral intake was sufficient, without tube feeding. After that discharge with home-tube feeding was routinely performed. Logistic regression analysis corrected for confounders.Results: Some 236 patients were included. The median duration of tube feeding was 35 days. Reoperation for a jejunostomy-related complication was needed in 2%. The median body mass index (BMI) remained stable during tube feeding. The BMI decreased significantly after stopping tube feeding: from 25.6 (1st-3rd 3.9% (1.5-6.3%)]. Weight loss was not affected by the duration of tube feeding duration. Routine home-tube feeding did not affect weight loss, admission time or the readmission rate.Conclusions: Weight loss following esophagectomy occurs once that tube feeding is stopped, independently from the time interval after esophagectomy. Moreover routine discharge with hometube feeding does not reduce length of stay or readmissions. These findings question the value of routine jejunostomy placement and emphasize the need for further research.

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Nutritional access routes following oesophagectomy—a systematic review

Cited by 35 publications

References 26 publications

Early enteral nutrition compared with parenteral nutrition for esophageal cancer patients after esophagectomy: a meta-analysis

Early enteral nutrition compared with parenteral nutrition for esophageal cancer patients after esophagectomy: a meta-analysis

S3-Leitlinie – Diagnostik und Therapie der Plattenepithelkarzinome und Adenokarzinome des Ösophagus

Routine jejunostomy tube feeding following esophagectomy

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