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A Prospective Randomized Trial Comparing Jejunostomy and Nasogastric Feeding in Minimally Invasive McKeown Esophagectomy

  • Zheng Tao
  • Yan Zhang
  • Shaojin Zhu
  • Zhengzheng Ni
  • Qi You
  • Xiaodong Sun
  • Dong XuEmail author
Original Article

Abstract

Background

Early postoperative enteral nutrition is recommended for patients undergoing esophagectomy; however, the optimum method of tube feeding remains controversial. Thus, the aim of this study is to assess two common enteral nutrition methods after minimally invasive McKeown esophagectomy.

Methods

A randomized controlled trial was performed with 120 patients who underwent minimally invasive McKeown esophagectomy from January 2017 to December 2018. The patients were randomly divided so that 58 patients were in the jejunostomy feeding (JF) group and 62 patients were in the nasogastric feeding (NF) group. The postoperative outcomes, including complications, nutritional status, quality of life, and survival rate, were studied and used as the main parameters to compare the abovementioned tube feeding methods.

Results

The incidence of overall complications was equivalent between the two groups (P = 0.625), except for bowel obstruction (which occurred 4 times in the JF group but did not occur in the NF group). In the first month after surgery (postoperative month 1, POM1), a significantly higher body mass index (BMI) was observed in the JF group (23.6 ± 3.2) than in the NF group (20.9 ± 3.5, P = 0.032). The global quality-of-life scores were better in the JF group than in the NF group (P < 0.001). In addition, there were no significant differences between the two groups in terms of disease-free survival (DFS) (P = 0.816) and overall survival (OS) (P = 0.564).

Conclusions

Compared with NF, JF provides more safety, efficacy, and utility as nutritional support for minimally invasive McKeown esophagectomy patients who have a high incidence of anastomotic leakage. However, the higher risk of intestinal obstruction after JF requires attention.

Keywords

Esophagectomy Jejunostomy Enteral nutrition Complications 

Notes

Author Contributions

Zheng Tao and Dong Xu contributed to the conception/design of the work; Qi You and Xiaodong Sun contributed to the acquisition of data; Yan Zhang and Shaojin Zhu contributed to the analysis/interpretation of data; Zheng Tao and Zhengzheng Ni drafted the manuscript. All authors approved the final version submitted and agree to be accountable for all aspects of the work.

Funding information

This study was supported by the Nature and Science Fund from Wannan Medical College, CN (Grant NO. WK2019F23,WK2018ZF10).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no competing interests and agree to publish this article.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2019

Authors and Affiliations

  1. 1.Department of Thoracic SurgeryThe First Affiliated Hospital of Wannan Medical CollegeWuhuChina

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