©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2019; 25(31): 4427-4436
Published online Aug 21, 2019. doi: 10.3748/wjg.v25.i31.4427
Published online Aug 21, 2019. doi: 10.3748/wjg.v25.i31.4427
Optimal timing and route of nutritional support after esophagectomy: A review of the literature
Richard Zheng, Courtney L Devin, Michael J Pucci, Adam C Berger, Ernest L Rosato, Francesco Palazzo, Department of Surgery, Thomas Jefferson University Hospital. Sidney Kimmel Medical College, Philadelphia University and Thomas Jefferson University, Philadelphia, PA 19107, United States
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting, critical revision, editing, and approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Corresponding author: Francesco Palazzo, FACS, MD, Assistant Professor, Doctor, Surgeon, Department of Surgery, Thomas Jefferson University Hospital, Sidney Kimmel Medical College, Philadelphia University and Thomas Jefferson University, 1100 Walnut St, 5th Floor, Philadelphia, PA 19107, United States. francesco.palazzo@jefferson.edu
Telephone: +1-215-5510360 Fax: +1-215-5518725
Received: May 9, 2019
Peer-review started: May 10, 2019
First decision: June 16, 2019
Revised: July 9, 2019
Accepted: July 19, 2019
Article in press: July 29, 2019
Published online: August 21, 2019
Processing time: 104 Days and 17 Hours
Peer-review started: May 10, 2019
First decision: June 16, 2019
Revised: July 9, 2019
Accepted: July 19, 2019
Article in press: July 29, 2019
Published online: August 21, 2019
Processing time: 104 Days and 17 Hours
Core Tip
Core tip: Early artificial enteral nutrition after esophagectomy is superior to total parenteral nutrition with regards to complication rate and functional recovery. Early direct oral nutrition appears to be safe in some patients, but there is some evidence associating early feeding with increased anastomotic leaks. For many patients who develop postoperative complications precluding oral intake, jejunostomy tubes remain an important option for nutritional delivery, although they are not without their own associated complications. Enhanced recovery pathways after surgery still vary in terms of these feeding techniques and schedules; more high-level evidence is required to make sweeping recommendations on early feeding after esophagectomy.