title: Post-esophagectomy tube feeding: a retrospective comparison of jejunostomy and a novel gastrostomy feeding approach.
abstract: BACKGROUND
  McKeown-type esophagectomy combined with retrosternal reconstruction is a common surgical treatment for esophageal cancer. Various enteral feeding options are available post-esophagectomy, but no definitive preference exists.
  
  
  METHODS
  "Retrosternal Route Gastrostomy Feeding (RGF)" was developed as an alternative enteral feeding approach that requires few additional surgical interventions. RGF is based on McKeown-type esophagectomy. We retrospectively compared RGF (n = 121) to jejunostomy feeding (JF) (n = 153) in 274 patients at the Department of Cardiothoracic Surgery in Changzheng Hospital (Shanghai, China) between June 2008 and Sept. 2012. Data pertaining to efficacy and procedural complications were compared among patients.
  
  
  RESULTS
  RGF had a significantly shorter postoperative hospital stay (11 vs. 15 days, p<0.001) and time to removal of the feeding tube (9 vs. 14 days, p<0.001) compared to JF. Bowel obstruction (0.0% vs. 7.2% p = 0.003), abdominal distension (9.1% vs. 19% p = 0.022), and the occurrence of pneumonia (11.6% vs. 26.1% p = 0.003) were significantly lower in the RGF group. Feeding tube related complications and the associated morbidity rate were reduced in the RGF group. The two groups had similar tolerance to surgery.
  
  
  CONCLUSIONS
  Our data suggests that RGF is a safe post-esophagectomy enteral feeding alternative to JF.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Shanghai Changzheng Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Kenan
authors.initials: K
authors.lastname: Huang
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Shanghai Changzheng Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wu
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Shanghai Changzheng Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Ding
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Shanghai Changzheng Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Zhifei
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Shanghai Changzheng Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Tang
mesh_terms: D000368:Aged; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D016629:Esophagectomy; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies