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Nasojejunal Tube Feeding After Minimally Invasive Esophagectomy
Ryan C. Banning, MD, Charles R. Mulligan, MD, Brian T. Nam, MD.
ChristianaCare Health System, Newark, DE, USA.

OBJECTIVE: Post-operative feeding methods after esophagectomy are varied and can be associated with potentially significant complications. Nasojejunal feeding is a reliable option that can offer significant advantages with minimal morbidity.
METHODS: A total of 18 consecutive patients undergoing MIE and nasojejunal tube feeding over a one yearperiod at a single center were reviewed since the institution of this method. Esophagectomy was performed in a minimally invasive Ivor-Lewis fashion utilizing a combined laparoscopic and thoracoscopic approach. A 10 Fr nasojejunal feeding tube was placed endoscopically at the completion of each procedure. Patient data including neoadjuvant treatment, stage, weight, tube-related complications,post-operative complications and outcomes were studied.
RESULTS: Seventeen of eighteen received neoadjuvant chemoradiation therapy and post-treatment stage ranged from IIb to IV. Average weight loss from pre-op to one month post-op was -5.8%. Anastomotic leak rate was 5.5%. Two patients developed dysphagia requiring balloon dilation and temporary stent placement. One tube was self-dislodged by the patient immediately post-operatively and was not replaced. There were no other tube-related complications including occlusion, migration or gastrointestinal issues. Patient received a median of 5 days of nutrition via tube feeding. Median LOS was 8.5 days. Thirty-day mortality rate was 0%.
CONCLUSIONS: Nasojejunal tube feeding after esophagectomy is a reliable option for post-operative nutrition with minimal morbidity.


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