Early oral feeding following McKeown minimally invasive esophagectomy: An open-label, randomized, controlled, noninferiority trial Journal Article
| Authors: | Sun, H. B.; Li, Y.; Liu, X. B.; Zhang, R. X.; Wang, Z. F.; Lerut, T.; Liu, C. C.; Fiorelli, A.; Chao, Y. K.; Molena, D.; Cerfolio, R. J.; Ozawa, S.; Chang, A. C.; written on behalf of the AME Thoracic Surgery Collaborative Group |
| Article Title: | Early oral feeding following McKeown minimally invasive esophagectomy: An open-label, randomized, controlled, noninferiority trial |
| Abstract: | Objective: Our objective was to evaluate the impact of early oral feeding (EOF) on postoperative cardiac, respiratory, and gastrointestinal (CRG) complications after McKeown minimally invasive esophagectomy for esophageal cancer. Summary Background Data: Nil-by-mouth with enteral tube feeding is routinely practiced after esophagectomy. Methods: Patients were randomly allocated to receive oral feeding on the first postoperative day (EOF group) or late oral feeding (LOF group) 7 days after surgery. The primary endpoint was the occurrence of postoperative CRG complications, and the secondary outcomes included bowel function recovery and short-term quality of life (QOL). Results: Between February 2014 and October 2015, 280 patients were enrolled in this study. There were 140 patients in the EOF group and 140 patients in the LOF group. EOF was noninferior to LOF for CRG complications (30.0% in the EOF group vs. 32.9% in the LOF group; 95% confidence interval of the difference: -13.8% to 8.0%). Compared with the LOF group, the EOF group showed significantly shorter time to first flatus (median of 2 days vs. 3 days, P = 0.001) and bowel movement (median of 3 vs. 4 days, P < 0.001). Two weeks after the operation, patients in the EOF group reported higher global QOL and function scores and lower symptom scores than patients in the LOF group. Conclusions: In patients after McKeown minimally invasive esophagectomy is noninferior to the standard of care with regard to postoperative CRG complications. In addition, patients in the EOF group had a quicker recovery of bowel function and improved short-term QOL. © 2017 Wolters Kluwer Health, Inc. All rights reserved. |
| Keywords: | adult; controlled study; treatment outcome; aged; major clinical study; conference paper; quality of life; bleeding; heart disease; randomized controlled trial; deep vein thrombosis; kidney failure; feeding; pneumonia; postoperative complication; confidence interval; length of stay; pneumothorax; heart failure; urinary tract infection; esophagus resection; sepsis; minimally invasive surgery; atelectasis; pleura effusion; bacteremia; intestine obstruction; heart arrhythmia; dietary intake; esophagus cancer; flatulence; wound infection; intestine function; gastrointestinal disease; esophageal cancer; respiratory tract disease; brain infarction; respiratory failure; adult respiratory distress syndrome; anastomosis leakage; fat necrosis; chylothorax; minimally invasive esophagectomy; effusion; stomach paresis; recurrent laryngeal nerve injury; mediastinitis; human; male; female; priority journal; intestine motility; early oral feeding; mckeown minimally invasive esophagectomy |
| Journal Title: | Annals of Surgery |
| Volume: | 267 |
| Issue: | 3 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2018-03-01 |
| Start Page: | 435 |
| End Page: | 442 |
| Language: | English |
| DOI: | 10.1097/sla.0000000000002304 |
| PROVIDER: | scopus |
| PUBMED: | 28549015 |
| PMCID: | PMC5937132 |
| DOI/URL: | |
| Notes: | Conference Paper -- Export Date: 2 April 2018 -- Source: Scopus |
