Enteral nutrition in postoperative rehabilitation after reconstructive esophageal and gastric surgery

Tarasova I.A.

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0001-9344-7351

Tskhovrebov A.T.

Petrovsky Russian Research Centre of Surgery

Bitarov T.T.

Petrovsky Russian Research Centre of Surgery

Boeva I.A.

Petrovsky Russian Scientific Center of Surgery

Gardashov N.M.

Petrovsky National Research Center of Surgery

Ivanova M.V.

Petrovsky National Research Center of Surgery

Shestakov A.L.

Petrovsky Russian Research Center of Surgery

Enteral nutrition in postoperative rehabilitation after reconstructive esophageal and gastric surgery

Authors:

Tarasova I.A., Tskhovrebov A.T., Bitarov T.T., Boeva I.A., Gardashov N.M., Ivanova M.V., Shestakov A.L.

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Journal: Pirogov Russian Journal of Surgery. 2023;(2): 35‑42

DOI: 10.17116/hirurgia202302135

Downloaded: 57

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To cite this article:

Tarasova IA, Tskhovrebov AT, Bitarov TT, Boeva IA, Gardashov NM, Ivanova MV, Shestakov AL. Enteral nutrition in postoperative rehabilitation after reconstructive esophageal and gastric surgery. Pirogov Russian Journal of Surgery. 2023;(2):35‑42. (In Russ.)
https://doi.org/10.17116/hirurgia202302135

Подписка 2025-2 (Pirogov Russian Journal of Surgery)

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OBJECTIVE

To investigate enteral nutrition as a component of postoperative rehabilitation after reconstructive esophageal and gastric surgeries.

MATERIAL AND METHODS

The study included 217 patients who underwent reconstructive esophageal and gastric surgeries between 2010 and 2020. In the main group (n=121), patients underwent postoperative enhanced recovery program (ERAS). Early enteral feeding including micro-jejunostomy and early oral feeding was essential for postoperative management. The control group included 96 patients who were treated in traditional fashion. The primary endpoint was length of hospital-stay (LOS) and ICU-stay. Restoration of gastrointestinal function (peristalsis, stool, oral nutrition), anastomotic leakage rate and other complications comprised secondary endpoints.

RESULTS

Both groups did not differ by sex, age, body mass index, diagnosis and comorbidities. There was significant reduction in postoperative LOS in the ERAS group (14 (12; 15.8) and 9 (6.3; 12) days, p<0.0001). In the same group, we observed less in ICU-stay (4.7 (3.6; 5.6) and to 3.5 (2; 4) days, p<0.001), earlier recovery of peristalsis and X-ray control of anastomosis in patients with and without anastomotic leakage. Incidence of respiratory complications was lower in the ERAS group (p=0.034). Overall postoperative morbidity and mortality were similar.

CONCLUSION

Early enteral and oral feeding after esophageal and gastric reconstructive surgery reduces hospital-stay and accelerates postoperative rehabilitation.

Keywords:

early enteral feeding

esophagectomy

gastrectomy

micro-jejunostomy

postoperative rehabilitation

enhanced recovery program

Authors:

Tarasova I.A.

Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0001-9344-7351

Tskhovrebov A.T.

Petrovsky Russian Research Centre of Surgery

Bitarov T.T.

Petrovsky Russian Research Centre of Surgery

Boeva I.A.

Petrovsky Russian Scientific Center of Surgery

Gardashov N.M.

Petrovsky National Research Center of Surgery

Ivanova M.V.

Petrovsky National Research Center of Surgery

Shestakov A.L.

Petrovsky Russian Research Center of Surgery

Received:

11.12.2021

Accepted:

10.06.2022

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