Sun Hai-bo, Liu Xian-ben, Zhang Rui-xiang, Wang Zong-fei, Qin Jian-jun, Yan Ming, Liu Bao-xing, Wei Xiu-feng, Leng Chang-sen, Zhu Jun-wei, Yu Yong-kui, Li Hao-miao, Zhang Jun, Li Yin
Department of Thoracic Surgery, Henan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, PR China.
Department of Thoracic Surgery, Henan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
Eur J Cardiothorac Surg. 2015 Feb;47(2):227-33. doi: 10.1093/ejcts/ezu168. Epub 2014 Apr 17.
Nil-by-mouth with enteral tube feeding is widely practised for several days after resection and reconstruction of oesophageal cancer. This study investigates early changes in postoperative gastric emptying and the feasibility of early oral feeding after thoracolaparoscopic oesophagectomy for patients with oesophageal cancer.
Between January 2013 and August 2013, gastric emptying of liquid food and the feasibility of early oral feeding after thoracolaparoscopic oesophagectomy was investigated in 68 patients. Sixty-five patients previously managed in the same unit who routinely took liquid food 7 days after thoracolaparoscopic oesophagectomy served as controls.
The mean preoperative half gastric emptying time (GET1/2) was 66.4 ± 38.4 min for all 68 patients, and the mean GET1/2 at postoperative day (POD) 1 and POD 7 was statistically significantly shorter than preoperative GET1/2 (23.9 ± 15.7 min and 24.1 ± 7.9 min, respectively, both P-values <0.001). Of the 68 patients who were enrolled to analyse the feasibility of early oral feeding, 2 (3.0%) patients could not take food as early as planned. The rate of total complication was 20.6% (14/68) and 29.2% (19/65) in the early oral feeding group and the late oral feeding group, respectively (P = 0.249). Compared with the late oral feeding group, time to first flatus and bowel movement was significantly shorter in the early oral feeding group.
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.
食管癌切除重建术后数天内广泛采用禁食并通过肠内管饲喂养。本研究调查食管癌患者经胸腹腔镜食管切除术后胃排空的早期变化以及早期经口进食的可行性。
2013年1月至2013年8月，对68例经胸腹腔镜食管切除术后的患者进行了液体食物胃排空情况及早期经口进食可行性的研究。65例此前在同一科室接受治疗、常规在经胸腹腔镜食管切除术后7天开始摄入液体食物的患者作为对照。
68例患者术前平均半胃排空时间（GET1/2）为66.4±38.4分钟，术后第1天（POD1）和术后第7天（POD7）的平均GET1/2在统计学上显著短于术前GET1/2（分别为23.9±15.7分钟和24.1±7.9分钟，P值均<0.001）。在68例纳入分析早期经口进食可行性的患者中，2例（3.0%）患者未能按计划尽早进食。早期经口进食组和晚期经口进食组的总并发症发生率分别为20.6%（14/68）和29.2%（19/65）（P = 0.249）。与晚期经口进食组相比，早期经口进食组首次排气和排便时间显著缩短。
与术前胃排空相比，食管切除术后早期液体食物的胃排空明显加快。经胸腹腔镜食管切除术后患者早期经口进食是可行且安全的。
