Intravenous hydration versus naso-jejunal enteral feeding after esophagectomy: a randomised study

Objective: Patients undergoing esophagectomy are typically nutritionally depleted and cannot establish oral feeding for up to a week after surgery. We have investigated the routine use of enteral feeding via a naso-jejunal tube. Methods: Forty consecutive patients undergoing a transthoracic esophagectomy for cancer were randomised to receive enteral feeding or intravenous crystalloid fluids after surgery. Nutritional indices were obtained prior to surgery and on the 7th post-operative day. Results: There were no post-operative deaths. Non-fatal complications occurred in 10 patients, without difference in morbidity between the two groups. Lean body mass did not change in either group over the study period. No differences in any other parameters were identified between the two groups. Conclusion: Enteral feeding via a naso-jejunal tube is safe and well tolerated after esophagectomy. It is a simple method of providing nutritional support prior to the re-introduction of oral feeding. However it provides no measurable benefit over intravenous hydration only for patients undergoing routine esophagectomy.