Retrograde gastric decompression and anterograde enteral nutrition feeding in retrosternal esophagectomy for esophageal cancer

Yang, Jingrong; Xia, Wenxuan; Ye, Shixin; Lian, Duohuang; Zhu, Jie; Wu, Jian; Zeng, Zhiyong

doi:10.1590/1806-9282.20250171

person Jingrong Yang

contributed equally to this work · Conceptualization · Investigation · Methodology · Visualization · Writing – original draft

schoolFujian Medical University, Fuzong Clinical Medical College – Fuzhou, China.schoolThe 900th Hospital of Joint Logistic Support Force, People's Liberation Army, Department of Cardiothoracic Surgery – Fuzhou, China.

0009-0008-1722-6061

person Wenxuan Xia

contributed equally to this work · Data curation · Formal Analysis · Visualization · Writing – review & editing

schoolFujian Medical University, The First School of Clinical Medicine – Fuzhou, China.

0009-0005-4423-9093

person Shixin Ye

Investigation · Resources · Writing – review & editing

schoolThe 900th Hospital of Joint Logistic Support Force, People's Liberation Army, Department of Cardiothoracic Surgery – Fuzhou, China.

0009-0008-7038-8828

person Duohuang Lian

Supervision · Validation · Writing – review & editing

schoolThe 900th Hospital of Joint Logistic Support Force, People's Liberation Army, Department of Cardiothoracic Surgery – Fuzhou, China.

0009-0000-9047-715X

person Jie Zhu

Funding acquisition · Methodology · Supervision

schoolThe 900th Hospital of Joint Logistic Support Force, People's Liberation Army, Department of Cardiothoracic Surgery – Fuzhou, China.

0009-0001-4278-4961

person Jian Wu

Writing – review & editing

schoolThe 900th Hospital of Joint Logistic Support Force, People's Liberation Army, Department of Cardiothoracic Surgery – Fuzhou, China.

0009-0008-5100-6070

person Zhiyong Zeng *

Project administration · Supervision · Writing – review & editing

schoolFujian Medical University, Fuzong Clinical Medical College – Fuzhou, China.schoolThe 900th Hospital of Joint Logistic Support Force, People's Liberation Army, Department of Cardiothoracic Surgery – Fuzhou, China.

0009-0006-6205-2705

person*Corresponding author: emailzzyong623@163.com

Conflicts of interest:

the authors declare there is no conflicts of interest.

Scientifıc Editor:

Roseli Nomura https://orcid.org/0000-0002-6471-2125

Parameters		RGDF group n=74	NGJ group n=68	p-value
Demography
	Onset age (mean±SD)	(58.1±13.1) years	(53.7±11.2) years	0.100
	Male, n (%)	52 (70.3%)	44 (64.7%)	0.501
	Female, n (%)	22 (29.7%)	24 (35.3%)	0.501
Location of lesion
	Upper third, n (%)	18 (24.3%)	17 (25.0%)	0.773
	Middle third, n (%)	43 (58.1%)	42 (61.8%)
	Lower third, n (%)	13 (17.6%)	9 (13.2%)
Histological type
	Squamous carcinoma, n (%)	69 (93.2%)	64 (94.1%)	0.935
	Adenocarcinoma, n (%)	3 (4.1%)	2 (2.9%)
	Others, n (%)	2 (2.7%)	2 (2.9%)
Depth of tumor invasion
	Tis, n (%)	3 (4.1%)	1 (1.5%)	0.912
	T1, n (%)	11 (14.9%)	9 (13.2%)
	T2, n (%)	31 (41.9%)	30 (44.1%)
	T3, n (%)	27 (36.5%)	26 (38.2%)
	T4, n (%)	2 (2.7%)	2 (2.9%)
Lymphatic metastasis
	N0, n (%)	33 (44.6%)	30 (45.6%)	0.797
	N1, n (%)	30 (40.5%)	28 (41.2%)
	N2, n (%)	8 (10.8%)	9 (13.2%)
	N3, n (%)	3 (4.1%)	1 (1.5%)
TNM stage
	Tis, n (%)	3 (4.1%)	1 (1.5%)	0.129
	I, n (%)	25 (33.8%)	29 (42.6%)
	II, n (%)	30 (40.5%)	32 (47.1%)
	III, n (%)	16 (21.6%)	6 (8.8%)

Parameters		RGDF group, n=74	NGJ group, n=68	p-value
Blood loss (mL), mean±SD		196.9±51.6	185.5±41.9	0.153
Operation time (min), mean±SD		183.0±41.7	169.4±32.6	0.031*
Surgical resection status
	R0 resection, n (%)	71 (95.9%)	66 (97.1%)	0.877
	R1 resection, n (%)	1 (1.4%)	1 (1.5%)
	R2 resection, n (%)	2 (2.7%)	1 (1.5%)
Harvested lymph node, mean±SD		13.7±5.1	12.5±3.9	0.120
Days of keeping a gastric tube for decompression, mean±SD		3.2±1.6	3.6±1.4	0.116
Days of keeping a feeding tube, mean±SD		23.7±7.6	22.5±8.1	0.364
ICU stay (days), mean±SD		3.2±1.0	3.5±1.2	0.107
LOHS (days), mean±SD		9.8±2.7	10.2±3.1	0.413
Postoperative drainage time (days), mean±SD		2.03±0.88	1.98±1.23	0.7797
Postoperative pain score		2.96±1.78	3.67±1.23	0.007*
Surgical complications, n (%)
	Recurrent laryngeal nerve injury	4 (5.4%)	3 (4.4%)	1.000
	Anastomotic leak	8 (10.8%)	7 (10.3%)	0.920
	Anastomotic stenosis	6 (8.1%)	4 (5.9%)	0.747
	Postoperative hemorrhage	1 (1.4%)	1 (1.5%)	1.000
	Chylothorax	2 (2.7%)	1 (1.5%)	1.000
	Cervical wound infection	1 (1.4%)	1 (1.5%)	1.000
	Respiratory complications	12 (16.2%)	11 (16.2%)	1.000
	Respiratory infections	8 (10.8%)	7 (10.3%)	0.920
	Respiratory failure	2 (2.7%)	1 (1.5%)	1.000
	Gastric emptying disorders	0 (0.0%)	0 (0.0%)	1.000
	Arrhythmia and other cardiac complications	3 (4.1%)	3 (4.5%)	1.000
Tube-related complications, n (%)		4 (5.4%)	7 (10.3%)	0.276
	Tube obstruction	1 (1.4%)	1 (1.5%)	1.000
	Wound infection	1 (1.4%)	Null	Null
	Peripheral leakage of the nutrient canal	2 (2.7%)	Null	Null
	Tube falling off	0 (0%)	3 (4.4%)	0.107
	Necrosis of the nasal alar	Null	1 (1.5%)	Null
	Nasosinusitis	Null	2 (2.9%)	Null
	In-hospital mortality, n (%)	1 (1.4%)	1 (1.5%)	1.000

[TFN1] RGDF: retrograde gastric decompression and feeding; NGJ: nasogastric-jejunal; SD: standard deviation; TNM: tumor, node, metastasis.