https://orcid.org/0000-0003-2071-4548
Dear Editor in Chief,
We really appreciate the letter from the readers and their interest in this review [Citation1]. The readers found a serious mistake that the study by Weijs et al. cited in the text wasn’t a randomized controlled trial (RCT) because of the retrospective nature of the control group [Citation2]. Therefore, the study design of this article should be considered as a retrospective case-control study, with an evidence level of 4 according to the Oxford Center for Evidence-Based Medicine 2011 Levels of Evidence [Citation3].
Early oral feeding (EOF) within 3 days following esophagectomy demonstrates its safety and promising efficacy in a few RCTs. However, the current available data are obviously insufficient. A meta-analysis based on the limited sample is not appropriate, which might result in misleading information for inexperienced surgeons, considering the potential risk of anastomotic leakage. Further large-scale, well-designed trials are warranted before a formal consensus or guideline supporting EOF in esophagectomy could be drawn.Yours sincerely,The authors.
References
- Zhang C, Zhang M, Gong L, et al. The effect of early oral feeding after esophagectomy on the incidence of anastomotic leakage: an updated review. Postgrad Med. 2020;132(5):419–425.
- Weijs TJ, Berkelmans GH, Nieuwenhuijzen GA, et al. Immediate postoperative oral nutrition following esophagectomy: a multicenter clinical trial. Ann Thorac Surg. 2016;102(4):1141–1148.
- Oxford Centre for Evidence-Based Medicine. Levels of evidence. 2011. Available from: http://www.cebm.net/index.aspx?o=5653