Sun Haibo, Li Yin, Liu Xianben, Wang Zongfei, Zhang Ruixiang, Qin Jianjun, Wei Xiufeng, Leng Changsen, Zhu Junwei, Chen Xiankai, Wu Zhao, Yu Yongkui, Li Haomiao
Department of Thoracic Surgery, The Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou 450008, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Sep;17(9):898-901.
To investigate the feasibility of no nasogastric intubation and early oral feeding at will after thoracolaparoscopic esophagectomy for patients with esophageal cancer.
Between January 2013 and January 2014, the feasibility of no nasogastric intubation and early oral feeding at postoperative day(POD) 1 after thoracolaparoscopic esophagectomy was prospectively investigated in 156 patients (trial group) with esophageal cancer in the Henan Cancer Hospital. One hundred and sixty patients previously managed in the same unit who were treated routinely after thoracolaparoscopic esophagectomy were served as control group.
Of 156 patients of trial group, 6(3.8%) patients could not take food early as planned because of postoperative complications. The overall complication rate in trial group was 19.2%(30/156), which was 25.0%(30/160) in control group (P=0.217). The anastomotic leakage in trial group and control group was 2.6%(4/156) and 4.3%(7/160) respectively (P=0.380). Compared with control group, time to first flatus [(2.1±0.9) d vs. (3.3±1.1) d, P<0.001], bowel movement [(4.4±1.3) d vs. (6.6±1.0) d, P<0.001] and postoperative hospital stay [(8.3±3.2) d vs. (10.4±3.6) d, P<0.001] were significantly shorter in trial group.
No nasogastric intubation and early oral feeding postoperatively in patients with thoracolaparoscopic esophagectomy is feasible and safe. This management can shorten postoperative hospital stay and fasten postoperative bowel function recovery.
探讨食管癌患者行胸腹腔镜联合食管癌切除术后不放置鼻胃管及早期随意经口进食的可行性。
2013年1月至2014年1月，河南省肿瘤医院对156例食管癌患者（试验组）行胸腹腔镜联合食管癌切除术后第1天不放置鼻胃管及早期随意经口进食的可行性进行了前瞻性研究。选取同一科室之前接受胸腹腔镜联合食管癌切除术并常规治疗的160例患者作为对照组。
试验组156例患者中，6例（3.8%）因术后并发症未能按计划早期经口进食。试验组总体并发症发生率为19.2%（30/156），对照组为25.0%（30/160）（P = 0.217）。试验组和对照组吻合口漏发生率分别为2.6%（4/156）和4.3%（7/160）（P = 0.380）。与对照组相比，试验组首次排气时间[（2.1±0.9）天对（3.3±1.1）天，P<0.001]、排便时间[（4.4±1.3）天对（6.6±1.0）天，P<0.001]和术后住院时间[（8.3±3.2）天对（10.4±3.6）天，P<0.001]明显缩短。
胸腹腔镜联合食管癌切除术后患者不放置鼻胃管及早期经口进食是可行且安全的。这种管理方式可缩短术后住院时间并加快术后肠道功能恢复。
