这项单中心队列研究的目的是比较在中心进行微创食管切除术 (MIE) 后直接经口喂养 (DOF) 与护理标准，术后并发症发生率稳定且可接受。

在这项单中心前瞻性队列研究中，患者在胸腔内吻合术的 MIE 后接受了术后 5 天的自由度（干预）或零口服和管饲（护理标准，对照组）。主要结果是功能恢复时间和住院时间。次要结局包括吻合口漏、肺炎和其他手术并发症。

干预组（n = 85）和对照组（n = 111）的基线特征相似。干预组和对照组功能恢复的中位时间分别为 7 天和 9 天（P < 0.001）。住院时间分别为 8 天和 10 天（P < 0.001）。干预组术后 30 天并发症发生率显着降低（57.6% vs 73.0%，P = 0.024）。仅对照组发生乳糜渗漏（18.9%，P < 0.001）。吻合口漏、肺炎和其他术后并发症在各组之间没有差异。与经口禁食的患者相比，MIE 后直接经口喂养可加快功能恢复时间并降低术后 30 天并发症发生率。

Abstract

Objective: The aim of this single-center cohort study was to compare direct oral feeding (DOF) to standard of care after a minimally invasive esophagectomy (MIE) performed in a center with a stable and acceptable postoperative complication rate.

Background: A recent multicenter, international randomized controlled trial showed that DOF following a MIE is comparable to standard of care (nil-by-mouth). However, the effect of DOF was potentially influenced by postoperative complications.

Methods: Patients in this single-center prospective cohort study received either DOF (intervention) or nil-by-mouth for 5 days postoperative and tube feeding (standard of care, control group) following a MIE with intrathoracic anastomosis. Primary outcome was time to functional recovery and length of hospital stay. Secondary outcomes included anastomotic leakage, pneumonia, and other surgical complications.

Results: Baseline characteristics were similar in the intervention (n = 85) and control (n = 111) group. Median time to functional recovery was 7 and 9 days in the intervention and control group (P < 0.001), respectively. Length of hospital stay was 8 versus 10 days (P < 0.001), respectively. Thirty-day postoperative complication rate was significantly reduced in the intervention group (57.6% vs 73.0%, P = 0.024). Chyle leakage only occurred in the control group (18.9%, P < 0.001). Anastomotic leakage, pneumonia, and other postoperative complications did not differ between groups.

Conclusion: Direct oral feeding following a MIE results in a faster time to functional recovery and lower 30-day postoperative complication rate compared to patients that were orally fasted.

原文链接

https://pubmed.ncbi.nlm.nih.gov/32541215/

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