Early enteral nutrition reduces the rate of life-threatening complications after thoracic esophagectomy in patients with esophageal cancer

Background: Early postoperative enteral nutrition has been suggested to improve the nutritional status of patients after esophageal surgery. However, whether enteral nutrition decreases rates of surgical complications and increases the completion rate of the clinical management pathway is unclear.

Methods: We analyzed 154 patients who were randomly assigned to either an enteral or parenteral nutrition group after undergoing esophagectomy, compared the incidence of surgical complications, and evaluated the completion rate of the clinical pathway. In these 2 patient groups, perioperative management was performed through identical clinical pathways, except for nutrition.

Results: The overall rate of surgical complications of any type did not differ between patients who received early enteral nutrition and those who did not (p = 0.50); however, the rate of life-threatening surgical complications was significantly lower in patients who received early enteral nutrition (p = 0.02). The rate of non-life-threatening surgical complications did not differ between the groups (p = 0.98). In patients who received enteral nutrition, the completion rate of the clinical pathway was higher (p = 0.03), and the postoperative hospital stay was shorter (p = 0.04).

Conclusions: Early enteral nutrition reduces the incidence of life-threatening surgical complications and improves the completion rate of the clinical pathway for thoracic esophagectomy.