Safety of Early Oral Feeding After Transhiatal Esophagectomy: Preliminary Report of A Prospective Trial

Oral feeding is the best means of nutrition in surgical patients. there are many reports on early oral feeding after lower gastrointestinal (gi) operations but data regarding upper gi procedures is rather scant. this limited study focuses on early removal of nasogastric tube and start of oral diet after transhiatal esophagectomy. we prospectively evaluated 13 consecutive patients (8 males, 5 females) with esophageal cancer who had undergone transhiatal esophagectomy from march 2001 to september 2003. nasogastric tube was removed on post-op day 2 and clear liquids started on day 3. diet was advanced to soft regular in the next 5 days if the patients tolerated it. mean age of patients was 63 years. mean body weight and serum albumin level were 57.9 kg and 3.73 gr/dl, respectively. tumor pathology was squamous cell carcinoma in 12 cases and adenocarcinoma in 1. location of tumor was at the lower third of the esophagus in 12 cases and middle third in one. all patients in the study group tolerated the protocol well. only one patient had nausea after oral intake, without vomiting. we had one neck wound infection and one pulmonary infection. there was no anastomotic leakage or fistula. a group of 10 esophageal cancer patients undergoing transhiatal esophagectomy in the same period were used as the control group. one anastomotic leakage occurred in control group. we had no significant complication. early nasogastric tube removal and oral feeding seems to be safe in patients with esophageal cancer undergoing transhiatal esophagectomy