Nutritional support and dietary interventions following esophagectomy: challenges and solutions

Figures & data

Figure 1 Summary of search strategy for systematic review.

Abbreviation: QOL, quality of life.

Table 1 Summary of included studies

Author	Design	Country	Outcome measures of interest	Assessment of quality
				Cochrane collaboration tool for assessment of risk of bias^Citation6 (randomized control trials)					Newcastle-Ottawa scale^Citation7 (cohort studies)
				Selection bias	Performance bias	Detection bias	Attrition bias	Reporting bias	Selection (/4)	Comparability (/2)	Outcome (/3)
Sun et al^Citation15	C	China	Postop complications	n/a	n/a	n/a	n/a	n/a	3	1	2
Wang et al^Citation16	C	China	Postop complications	n/a	n/a	n/a	n/a	n/a	3	1	1
Kobayashi et al^Citation17	C	Japan	Postop complications	n/a	n/a	n/a	n/a	n/a	3	1	2
Tomaszek et al^Citation18	C	USA	Postop complications	n/a	n/a	n/a	n/a	n/a	4	1	2
Bowrey et al^Citation19	R	UK	Nutrition, nutrition-related QOL, cost	Low	High	High	Low	Low	n/a	n/a	n/a
Barlow et al^Citation12	R	UK	Postop complications	Low	High	High	Low	Low	n/a	n/a	n/a
Page et al^Citation20	R	UK	Postop complications	Unclear	High	High	Low	Low	n/a	n/a	n/a
Watters et al^Citation21	R	Canada	Postop complications	High	High	High	Low	Low	n/a	n/a	n/a
Xiao-Bo et al^Citation22	R	China	Postop complications	Unclear	High	High	Low	Low	n/a	n/a	n/a
Fujita et al^Citation23	R	Japan	Postop complications	Unclear	High	No	Low	Low	n/a	n/a	n/a
Seike et al^Citation13	R	Japan	Postop complications	Low	High	High	Low	Low	n/a	n/a	n/a
Cooper et al^Citation24	R	UK	Postop complications	Low	High	High	Low	Low	n/a	n/a	n/a
Gabor et al^Citation25	C	Austria	Postop complications	n/a	n/a	n/a	n/a	n/a	4	1	2
Shiraishi et al^Citation26	C	Japan	Postop complications	n/a	n/a	n/a	n/a	n/a	3	1	3
Aiko et al^Citation27	R	Japan	Postop complications	Unclear	High	High	Low	Low	n/a	n/a	n/a
Baigrie et al^Citation28	R	Australia	Postop complications	Unclear	High	High	Low	Low	n/a	n/a	n/a
Oya et al^Citation29	C	Japan	Postop complications	n/a	n/a	n/a	n/a	n/a	3	1	2
Huang et al^Citation30	C	China	Postop complications	n/a	n/a	n/a	n/a	n/a	4	1	2
Han-Geurts et al^Citation31	R	The Netherlands	Postop complications	High	High	High	Low	Low	n/a	n/a	n/a
Srinathan et al^Citation32	C	Canada	Postop complications	n/a	n/a	n/a	n/a	n/a	4	0	2
Llaguna et al^Citation8	C	USA	Postop complications	n/a	n/a	n/a	n/a	n/a	3	0	2
Fenton et al^Citation33	C	USA	Postop complications	n/a	n/a	n/a	n/a	n/a	3	0	2
Wani et al^Citation34	C	India	Postop complications	n/a	n/a	n/a	n/a	n/a	4	0	2
Gupta^Citation35	C	India	Postop complications	n/a	n/a	n/a	n/a	n/a	4	0	2
Ryan et al^Citation36	C	Ireland	Postop complications, nutrition	n/a	n/a	n/a	n/a	n/a	4	0	2
Sica et al^Citation37	C	UK	Postop complications	n/a	n/a	n/a	n/a	n/a	4	0	2
Yagi et al^Citation38	C	Japan	Postop complications	n/a	n/a	n/a	n/a	n/a	4	0	2
McCarter et al^Citation39	C	USA	Postop complications	n/a	n/a	n/a	n/a	n/a	4	0	2
Wakefield et al^Citation40	C	UK	Postop complications	n/a	n/a	n/a	n/a	n/a	3	0	2
Gerndt and Orringer^Citation41	C	USA	Postop complications	n/a	n/a	n/a	n/a	n/a	3	0	2
Huddy et al^Citation14	C	UK	Gastrointestinal symptoms	n/a	n/a	n/a	n/a	n/a	3	0	2
Deldycke et al^Citation42	C	Belgium	Symptoms	n/a	n/a	n/a	n/a	n/a	3	0	2
Heneghan et al^Citation9	C	Ireland	Symptoms	n/a	n/a	n/a	n/a	n/a	2	0	2
Greene et al^Citation11	C	USA	Symptoms, nutrition-related QOL	n/a	n/a	n/a	n/a	n/a	4	0	2
Carey et al^Citation43	R	Australia	Nutrition, symptoms, nutrition-related QOL	High	Low	High	Low	Low	n/a	n/a	n/a
Carey et al^Citation10	C	Australia	Nutrition-related QOL	n/a	n/a	n/a	n/a	n/a	2	0	2
Wang et al^Citation44	C	China	Nutrition-related QOL	n/a	n/a	n/a	n/a	n/a	3	1	2
Djarv et al^Citation45	C	Sweden	Nutrition-related QOL	n/a	n/a	n/a	n/a	n/a	3	0	2
Haverkort et al^Citation4	C	The Netherlands	Symptoms	n/a	n/a	n/a	n/a	n/a	2	0	2
Parameswaran et al^Citation46	C	UK	Symptoms, nutrition-related QOL	n/a	n/a	n/a	n/a	n/a	3	0	2
Aghajanzadeh et al^Citation47	C	Iran	Symptoms, nutrition-related QOL	n/a	n/a	n/a	n/a	n/a	3	0	2
Martin et al^Citation48	C	Sweden	Symptoms	n/a	n/a	n/a	n/a	n/a	4	0	2
Viklund et al^Citation49	C	Sweden	Symptoms, nutrition-related QOL	n/a	n/a	n/a	n/a	n/a	4	2	2
Ludwig et al^Citation50	C	USA	Symptoms	n/a	n/a	n/a	n/a	n/a	3	0	2
McLarty et al^Citation51	C	USA	Symptoms, nutrition-related QOL	n/a	n/a	n/a	n/a	n/a	3	0	1
Finley et al^Citation52	C	Canada	Symptoms	n/a	n/a	n/a	n/a	n/a	2	0	2
Ginex et al^Citation53	C	USA	Symptoms	n/a	n/a	n/a	n/a	n/a	3	0	2

Notes: The Newcastle-Ottawa scores three domains, selection criteria (scored out of 4), comparability (scored out of 2) and outcomes reporting (scored out of 3). Higher scores indicate lower risk of bias from that variable. The Cochrane Collaborative tool triages bias in randomized controlled trials into low risk, high risk or uncertain risk.

Abbreviations: C, cohort study; n/a, not applicable; QOL, quality of life; R, randomized controlled trial; Postop, postoperative.

Table 2 Summary of studies comparing the timing of reintroduction of oral/enteral intake

Study	Design	Sample	Early feeding regimen	Late feeding regimen	Principal study findings
Sun et al^Citation15	C	135	Oral fluid diet at will from postoperative day 1 (after negative gastric emptying test on the same day); n=68	Enteral feeding by jejunostomy or nasoenteral tube; commencement of oral liquid diet on postoperative day 7; n=65	Reduced length of ileus and length of hospital stay in early feeding group No difference in overall complications between two groups
Wang et al^Citation16	C	208	Two early enteral nutrition groups; Group 1- feed started within 48 h (n=101), Group 2 feed started 48–72 h (n=87); by nasojejunal tube	Group 3: start of enteral nutrition >72 h; by nasojejunal tube (n=20)	Reduced length of ileus and length of hospital stay in Group I Higher rate of pneumonia in delayed feeding group (Group 3) compared to Group I No difference in anastomotic leak rate between groups
Kobayash^Citation17	C	103	Enteral nutrition started within 3 days of surgery by jejunostomy; n=43	Enteral nutrition started after postoperative day 3 by jejunostomy; n=61	Reduced length of ileus and length of hospital stay in early feeding group No difference in postoperative complications between groups
Tomaszek et al^Citation18	C	386	Oral diet commenced at postoperative day 5–7 following negative contrast swallow study (conventional pathway); n= 110	Feeding by jejunostomy only until postoperative week 4 (alternative pathway); n=276	Reduced length of hospital stay in early feeding group Radiologic anastomotic leak rate lower in late feeding group

Abbreviation: C, cohort study.

Table 3 Summary of studies comparing enteral feeding with usual care

Study	Design	Sample	Enteral feeding regimen	Length of hospital stay in days (mean±SD)	Usual care regimen	Length of hospital stay in days (mean±SD)	Duration of follow-up	Principal study findings
Bowrey et al^5,Table Footnotea	R	54	Jejunostomy: 6 weeks of overnight feeding at home to provide at least 50% of calorific requirements; n=20	19±7	No home feeding unless clinically indicated; n=21	16±7	26 weeks	High levels of compliance with patient/carer jejunostomy tube care and feeding No difference in mean cost between two arms Control group lost on average 4 kg more than intervention group at 6 weeks, with differences maintained at 3 and 6 months
Barlow et al^12,Table Footnoteb	R	121	Jejunostomy: 20–80 mL/h of feed commenced within 12 h of surgery until hospital discharge; n=64	16* (IQR 9)	Intravenous fluids only until oral diet recommenced (day 7–10); n=57	19* (IQR 11)	12 weeks	Reduced rate of wound/chest infections and reduced length of hospital stay in enterally fed group
Page et al^Citation20	R	40	Nasojejunal: 25–100 mL/h of feed until oral fluid intake reestablished; n=20	14±5	Intravenous fluids until oral diet recommenced (day 7–10); n=20	13±5	1 week	Feed safe and well tolerated No difference in postoperative complications between groups
Watters et al^Citation21	R	28	Jejunostomy: 20–80 mL/h of feed until hospital discharge; n= 13	17±9	Intravenous fluids until oral diet recommenced (day 6); n=15	16±7	1 week	No difference in hand grip strength, fatigue or vigor between groups Reduced FEV1 and FVC in enterally fed group

Notes:

a Included some patients having total gastrectomy,

b included some patients having gastrectomy and pancreatectomy,

* median values are quoted in study.

Abbreviations: FEV_1, forced expiratory volume in 1 second; FVC, forced vital capacity; IQR, interquartile range; R, randomized controlled trial; SD, standard deviation.

Table 4 Summary of studies comparing enteral with parenteral feeding

Study	Design	Sample	Enteral feeding regimen	Parenteral feeding regimen	Principal study findings
Xiao-Bo et al^Citation22	R	120	Nasojejunal: 40–100 mL/h started on day 1, n=64	7 days, n=56	Earlier restoration of inflammatory markers, lower rates of postoperative infections, reduced duration of ileus and lower nutritional costs in enterally fed group No difference in serious complications or length of hospital stay between groups
Fujita et al^Citation23	R	154	Jejunostomy: 10–80 mL/h during days 1–6, n=76	6 days by peripheral line (calories), n=88	Reduced rate of life-threatening complications, shorter length of hospital stay, higher completion rate of planned clinical management pathway in enterally fed group No difference in overall complications between groups
Seike et al^Citation13	R	30	Jejunostomy: 10–60 mL/h during days 1–8, n=15	8 days at 2000 kcal daily, n=15	No difference in postoperative complications or serum immunologic markers between groups
Cooper et al^Citation24	R	27	Oral diet commenced at postoperative day 4, n=11	7 days at 1500 kcal daily, n=16	Reduced 90-day mortality in parenterally fed group No difference in 1-year mortality between groups
Gabor et al^Citation25	C	88	Nasojejunal: 10–80 mL/h days 0–6, n=44	7 days by central line, n=44	Reduced duration of ileus and length of hospital stay in enterally fed group No difference in wound infection or anastomotic leak rate between groups
Shiraishi et al^Citation26	C	15	250–2000 kcal daily days 1–5, N=8	8 days, n=7	No difference in biochemical markers or complication rate between groups Lower costs in enterally fed group
Aiko et al^Citation27	C	24	Jejunostomy: 500–1500 mL daily days 1–5, n=13	5 days by central line, n=11	No difference in complications or length of hospital stay between groups Reduced levels of immunologic markers in enterally fed group
Baigrie et al^Citation28	R	97	Jejunostomy: 100 kcal daily days 4–7, n=50	7 days by central line, n=47	No difference in mortality between groups Higher rate of catheter-related sepsis in parenterally fed group

Abbreviations: C, cohort; R, randomized controlled trial.

Table 5 Studies comparing different routes of enteral access

Study	Design	Sample	Intervention route	Comparator route	Principal study findings
Oya et al^Citation29	C	378	Duodenostomy, n=111	Jejunostomy, n=267	Fewer catheter site infections with duodenostomy (1% vs 5%, p=0.08) Reduced length of hospital stay with duodenostomy (mean 15 vs 37 days, p<0.001)
Huang et al^Citation30	C	274	Retrosternal route gastrostomy, n=121	Jejunostomy, n=153	Use of gastrostomy associated with lower risk of intestinal obstruction (0% vs 7%, p=0.003), catheter-related infection (2% vs 6%, p=0.05) and reduced length of hospital stay (11 vs 15 days, p<0.001)
Han-Guerts et al^Citation31	R	150	Nasoduodenal tube, n=71	Jejunostomy, n=79	No differences in tolerance of enteral feeding (93% vs 89%) or rates of catheter-related complications (29% vs 38%) between groups

Abbreviations: C, cohort; R, randomized controlled trial.

Table 6 Jejunostomy-related complications (studies reporting on ≥50 patients)

Author	No. of subjects	Feeding regimen (feed type)	Tube-related mortality (%)	Need for operative intervention (%)	Complications
					Tube dysfunction	Tube exit site problems	Gastrointestinal side effects
Huang et al^Citation30	153	N/S	N/S	N/S	2% Dislodged 6% Occlusion 7% Peritonitis	7% Infection	N/S
Srinathan et al^Citation32	103	N/S for 8* days (standard polymeric formula)	1	3	7% Occlusion 2% Dislodged	3% Infection	39% All side effects
Llaguna et al^Citation8	73	N/S	0	20	10% Dislodged 1 % Occlusion	8% Infection 7% Leakage	N/S
Fenton et al^Citation33	143	N/S	0	1	4% Occlusion	13% Infection	N/S
Wani et al^Citation34	463	35–40 kcal/kg daily for 19* days (N/S)	N/S	2	7% Occlusion	N/S	9% Diarrhea 3% Distension
Gupta^Citation35	203	35–40 kcal/kg daily for 17* days (N/S)	N/S	N/S	6% Occlusion	N/S	8% Diarrhea 7% Distension
Han-Geurts et al^Citation31	79	30–84 mL/h for 10 days (isotonic Nutrison standard)	0	1	6% Occlusion 11% Dislodged	16% Infection 4% Leakage	N/S
Ryan et al^Citation36	205	30–100 mL/h for 20 h daily (isotonic Fresubin original)	0.5	1	3% Occlusion	1% Infection	11 % Diarrhea 4% Distension 18% Constipation
					2% Dislodged
Sica et al^Citation37	262	30–110 mL/h for 14* days (isotonic Osmolite standard)	1	2	0% Occlusion 1 % Dislodged	1% Infection	N/S
Yagi et al^Citation38	78	1290* kcal daily for up to 69* days (N/S)	0	0	0%	4% Infection	6% Diarrhea 4% Distension
McCarter et al^Citation39	167	25–100 mL/h daily for 8 days (isotonic Osmolite HN)	0	N/S	6% Malfunction, dislodged or occlusion	N/S	9% Cramps 18% Distension 4% Nausea 24% Diarrhea
Wakefield et al^Citation40	58	25–100 mL/h daily for 7 days (Nutrison standard)	0	2	5% Dislodged 2% Occlusion	5% Infection	N/S
Gerndt and Orringer^Citation41	523	N/S	0	N/S	0.5% Dislodged	0.5% Leakage 0.5% Stitch abscess	N/S

Notes:

* Mean values. The table shows the frequency of gastrointestinal side effects mandating a change in the feeding protocol, either feed cessation, change to a different formula or change in the infusion rate.

Abbreviation: N/S, not stated.

Table 7 Summary of studies reporting on postesophagectomy gastrointestinal symptoms

Author	Symptom/nutrition-related QOL assessment tool	No. of subjects	Duration of follow-up	Symptom prevalence
				Dumping syndrome (%)	Dysphagia (%)	Early satiety (%)	Odynophagia (%)	Reflux symptoms (%)
Deldycke et al^Citation42	Institutional questionnaire (available online)	322	9 months to 12 years	21	36	N/S	N/S	39
Greene et al^Citation11	GI Quality of Life Index, SF-36	63	10–38 years	43	11	40	N/S	19
Ginex et al^Citation53,Table Footnotea	Memorial	185	Baseline	N/S	31	N/S	N/S	27
	Symptom	140	Postoperative	N/S	29	N/S	N/S	23
	Assessment Scale	111	6 months	N/S	30	N/S	N/S	38
		98	12 months	N/S	21	N/S	N/S	45
Djarv et al^Citation45	EORTC QLQ-C30 and OES-18	401	6 months	N/S	9	N/S	37	N/S
Haverkort et al^Citation4	Institutional questionnaire	80	1 week	74	N/S	89	N/S	60
		76	3 months	78	N/S	87	N/S	54
		69	6 months	78	N/S	87	N/S	65
		59	12 months	75	N/S	90	N/S	61
Aghajanzadeh et al^Citation47	Institutional questionnaire, SF36	194	12–48 months	61	34	N/S	6	19
Ludwig et al^Citation50	Institutional questionnaire	48	36 months	15	38	N/S	N/S	25
McLarty et al^Citation51	Institutional questionnaire, SF-36	107	5–23 years	50	21	N/S	N/S	29
Finley et al^Citation52	Institutional questionnaire	283	3 months	5	36	N/S	N/S	5
				Symptom score
Wang et al^44,Table Footnoteb	EORTC QLQ-C30 and OES-18	97	2 weeks	N/S	39	N/S	N/S	29
			4 weeks	N/S	31	N/S	N/S	31
			12 weeks	N/S	24	N/S	N/S	35
			24 weeks	N/S	24	N/S	N/S	35
Djarv et al^45,Table Footnoteb,Table Footnotec	EORTC QLQ-C30 and OES-18	401	6 months (mean)	N/S	24	N/S	27	N/S
			6 months (median)	N/S	22	N/S	22	N/S
Haverkort et al^4,Table Footnoted	Institutional questionnaire	80	1 week	3.7	3.3	N/S	N/S	N/S
		76	3 months	3.9	3.4	N/S	N/S	N/S
		69	6 months	3.8	3.5	N/S	N/S	N/S
		59	12 months	3.9	3.5	N/S	N/S	N/S
Parameswaran et al^Citation46	EORTC QLQ-C30 and OES-18	55	Baseline	3	25	N/S	14	21
		46	6 months	13	18	N/S	15	5
		40	12 months	13	16	N/S	18	26
Martin et al^48,Table Footnoted	EORTC QLQ-C30 and OES-18	226	6 months	N/S	23	N/S	26	25
Viklund et al^49,Table Footnoteb	EORTC QLQ-C30 and OES-18	282	6 months	N/S	25	N/S	26	26

Notes: Haverkort et al⁴ employed a scoring tool ranging from 0 to 7 for each symptom. The EORTC tools^58,59 use scores in the range 0–100, with higher symptom scores indicating more severe symptoms. Extrapolated from Ginex et al.⁵³

b mean value reported

c median value reported

d weighted mean reported.

Abbreviations: N/S, not stated; QOL, quality of life; EORTC QLQ and OES-18, European Organization for Research and Treatment of Cancer and Oesophago-gastric disease specific 18; SF36, Short form (36 item).

Higgins JPT, Altman DG, Gøtzsche PC, et al; Cochrane Bias Methods Group; Cochrane Statistical Methods Group. The cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.

 PubMed Web of Science ®Google Scholar

Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality if nonrandomized studies in meta-analyses; 2009. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm. Accessed Jauary 25, 2017.

 Google Scholar

Sun HB, Liu XB, Zhang RX, et al. Early oral feeding following thoracolaparoscopic oesophagectomy for oesophageal cancer. Eur J Cardiothorac Surg. 2015;47(2):227–233.

 PubMed Web of Science ®Google Scholar

Wang G, Chen H, Liu J, Ma Y, Jia H. A comparison of postoperative early enteral nutrition with delayed enteral nutrition in patients with esophageal cancer. Nutrients. 2015;7(6):4308–4317.

 Web of Science ®Google Scholar

Kobayashi K, Koyama Y, Kosugi S, et al. Is early enteral nutrition better for postoperative course in esophageal cancer patients? Nutrients. 2013;5(9):3461–3469.

 PubMed Web of Science ®Google Scholar

Tomaszek SC, Cassivi SD, Allen MS, et al. An alternative postoperative pathway reduces length of hospitalisation following oesophagectomy. Eur J Cardiothorac Surg. 2010;37(4):807–813.

 Web of Science ®Google Scholar

Bowrey DJ, Baker M, Halliday V, et al. A randomised controlled trial of six weeks of home enteral nutrition versus standard care after oesophagectomy or total gastrectomy for cancer: report on a pilot and feasibility study. Trials. 2015;16:531.

 PubMed Web of Science ®Google Scholar

Barlow R, Price P, Reid TD, et al. Prospective multicentre randomised controlled trial of early enteral nutrition for patients undergoing major upper gastrointestinal surgical resection. Clin Nutr. 2011;30(5):560–566.

 PubMed Web of Science ®Google Scholar

Page RD, Oo AY, Russell GN, Pennefather SH. Intravenous hydration versus naso-jejunal enteral feeding after esophagectomy: a randomised study. Eur J Cardiothorac Surg. 2002;22(5):666–672.

 Web of Science ®Google Scholar

Watters JM, Kirkpatrick SM, Norris SB, Shamji FM, Wells GA. Immediate postoperative enteral feeding results in impaired respiratory mechanics and decreased mobility. Ann Surg. 1997;226(3):369–377.

 PubMed Web of Science ®Google Scholar

Xiao-Bo Y, Qiang L, Xiong Q, et al. Efficacy of early postoperative enteral nutrition in supporting patients after esophagectomy. Minerva Chir. 2014;69(1):37–46.

 PubMed Web of Science ®Google Scholar

Fujita T, Daiko H, Nishimura M. Early enteral nutrition reduces the rate of life-threatening complications after thoracic esophagectomy in patients with esophageal cancer. Eur Surg Res. 2012;48(2):79–84.

 PubMed Web of Science ®Google Scholar

Seike J, Tangoku A, Yuasa Y, Okitsu H, Kawakami Y, Sumitomo M. The effect of nutritional support on the immune function in the acute postoperative period after esophageal cancer surgery: total parenteral nutrition versus enteral nutrition. J Med Invest. 2011;58(1–2):75–80.

 Google Scholar

Cooper SC, Hulley CM, Grimley CE, et al. Perioperative peripheral parenteral nutrition for patients undergoing esophagectomy for cancer: a pilot study of safety, surgical, and nutritional outcomes. Int Surg. 2006;91(6):358–364.

 Web of Science ®Google Scholar

Gabor S, Renner H, Matzi V, et al. Early enteral feeding compared with parenteral nutrition after oesophageal or oesophagogastric resection and reconstruction. Br J Nutr. 2005;93(4):509–513.

 PubMed Web of Science ®Google Scholar

Shiraishi T, Kawahara K, Yamamoto S, Maekawa T, Shirakusa T. Postoperative nutritional management after esophagectomy: is TPN the standard of nutritional care? Int Surg. 2005;90(1):30–35.

 Web of Science ®Google Scholar

Aiko S, Yoshizumi Y, Sugiura Y, et al. Beneficial effects of immediate enteral nutrition after esophageal cancer surgery. Surg Today. 2001;31(11):971–978.

 Web of Science ®Google Scholar

Baigrie RJ, Devitt PG, Watkin DS. Enteral versus parenteral nutrition after oesophagogastric surgery: a prospective randomized comparison. Aust N Z J Surg. 1996;66(10):668–670.

 PubMedGoogle Scholar

Oya H, Koike M, Iwata N, et al. Feeding duodenostomy decreases the incidence of mechanical obstruction after radical esophageal cancer surgery. World J Surg. 2015;39(5):1105–1110.

 Web of Science ®Google Scholar

Huang K, Wu B, Ding X, Xu Z, Tang H. Post-esophagectomy tube feeding: a retrospective comparison of jejunostomy and a novel gastrostomy feeding approach. PLoS One. 2014;9(3):e89190.

 Web of Science ®Google Scholar

Han-Geurts IJ, Hop WC, Verhoef C, Tran KT, Tilanus HW. Randomized clinical trial comparing feeding jejunostomy with nasoduodenal tube placement in patients undergoing oesophagectomy. Br J Surg. 2007;94(1):31–35.

 PubMed Web of Science ®Google Scholar

Srinathan SK, Hamin T, Walter S, Tan AL, Unruh HW, Guyatt G. Jejunostomy tube feeding in patients undergoing esophagectomy. Can J Surg. 2013;56(6):409–414.

 Web of Science ®Google Scholar

Llaguna OH, Kim HJ, Deal AM, Calvo BF, Stitzenberg KB, Meyers MO. Utilization and morbidity associated with placement of a feeding jejunostomy at the time of gastroesophageal resection. J Gastrointest Surg. 2011;15(10):1663–1669.

 Web of Science ®Google Scholar

Fenton JR, Bergeron EJ, Coello M, Welsh RJ, Chmielewski GW. Feeding jejunostomy tubes placed during esophagectomy: are they necessary? Ann Thorac Surg. 2011;92(2):504–511; discussion 511–512.

 Web of Science ®Google Scholar

Wani ML, Ahangar AG, Lone GN, et al. Feeding jejunostomy: does the benefit overweight the risk (a retrospective study from a single centre). Int J Surg. 2010;8(5):387–390.

 PubMed Web of Science ®Google Scholar

Gupta V. Benefits versus risks: a prospective audit. Feeding jejunostomy during oesophagectomy. World J Surg. 2009;33(7):1432–1438.

 Web of Science ®Google Scholar

Ryan AM, Rowley SP, Healy LA, Flood PM, Ravi N, Reynolds JV. Post-oesophagectomy early enteral nutrition via a needle catheter jejunostomy: 8-year experience at a specialist unit. Clin Nutrition. 2006;25(3):386–393.

 PubMed Web of Science ®Google Scholar

Sica GS, Sujendran V, Wheeler J, Soin B, Maynard N. Needle catheter jejunostomy at esophagectomy for cancer. J Surg Oncol. 2005;91(4):276–279.

 Web of Science ®Google Scholar

Yagi M, Hashimoto T, Nezuka H, et al. Complications associated with enteral nutrition using catheter jejunostomy after esophagectomy. Surg Today. 1999;29(3):214–218.

 Web of Science ®Google Scholar

McCarter MD, Gomez ME, Daly JM. Early postoperative enteral feeding following major upper gastrointestinal surgery. J Gastrointest Surg. 1997;1(3):278–285.

 Google Scholar

Wakefield SE, Mansell NJ, Baigrie RJ, Dowling BL. Use of a feeding jejunostomy after oesophagogastric surgery. Br J Surg. 1995;82(6):811–813.

 Web of Science ®Google Scholar

Gerndt SJ, Orringer MB. Tube jejunostomy as an adjunct to esophagectomy. Surgery. 1994;115(2):164–169.

 PubMed Web of Science ®Google Scholar

Huddy JR, Macharg FMS, Lawn AM, Preston SR. Exocrine pancreatic insufficiency following esophagectomy. Dis Esophagus. 2013;26(6):594–597.

 PubMed Web of Science ®Google Scholar

Deldycke A, Van Daele E, Ceelen W, Van Nieuwenhove Y, Pattyn P. Functional outcome after Ivor Lewis esophagectomy for cancer. J Surg Oncol. 2016;113(1):24–28.

 Web of Science ®Google Scholar

Heneghan HM, Zaborowski A, Fanning M, et al. Prospective study of malabsorption and malnutrition after esophageal and gastric cancer surgery. Ann Surg. 2015;262(5):803–807.

 PubMed Web of Science ®Google Scholar

Greene CL, DeMeester SR, Worrell SG, Oh DS, Hagen JA, DeMeester TR. Alimentary satisfaction, gastrointestinal symptoms, and quality of life 10 or more years after esophagectomy with gastric pull-up. J Thorac Cardiovasc Surg. 2014;147(3):909–914.

 PubMed Web of Science ®Google Scholar

Carey S, Storey D, Biankin AV, Martin D, Young J, Allman-Farinelli M. Long term nutritional status and quality of life following major upper gastrointestinal surgery – a cross-sectional study. Clin Nutr. 2011;30(6):774–779.

 Web of Science ®Google Scholar

Carey S, Laws R, Ferrie S, Young J, Allman-Farinelli M. Struggling with food and eating—life after major upper gastrointestinal surgery. Support Care Cancer. 2013;21(10):2749–2757.

 Web of Science ®Google Scholar

Wang H, Tan L, Feng M, Zhang Y, Wang Q. Comparison of the short-term health-related quality of life in patients with esophageal cancer with different routes of gastric tube reconstruction after minimally invasive esophagectomy. Qual Life Res. 2011;20(2):179–189.

 Web of Science ®Google Scholar

Djarv T, Blazeby JM, Lagergren P. Predictors of postoperative quality of life after esophagectomy for cancer. J Clin Oncol. 2010;27(12):1963–1968.

 Web of Science ®Google Scholar

Haverkort EB, Binnekade JM, Busch ORC, van Berge Henegouwen MI, de Haan RJ, Gouma DJ. Presence and persistence of nutrition-related symptoms during the first year following esophagectomy with gastric tube reconstruction in clinically disease-free patients. World J Surg. 2010;34(12):2844–2852.

 PubMed Web of Science ®Google Scholar

Parameswaran R, Blazeby J, Hughes R, Mitchell K, Berrisford R, Wajed S. Health-related quality of life after minimally invasive oesophagectomy. Br J Surg. 2010;97(4):525–531.

 PubMed Web of Science ®Google Scholar

Aghajanzadeh M, Safarpour F, Koohsari MR, Ghanaei FM, Bodaghi SM, Tozandehgani H. Functional outcome of gastrointestinal tract and quality of life after esophageal reconstruction of esophagus cancer. Saudi J Gastroenterol. 2009;15(1):24–28.

 Google Scholar

Martin L, Lagergren J, Lindblad M, Rouvelas I, Lagergren P. Malnutrition after oesophageal cancer surgery in Sweden. Br J Surg. 2007;94(12):1496–1500.

 PubMed Web of Science ®Google Scholar

Viklund P, Wengström Y, Rouvelas I, Lindblad M, Lagergren J. Quality of life and persisting symptoms after oesophageal cancer surgery. Eur J Cancer. 2006;42(10):1407–1414.

 Web of Science ®Google Scholar

Ludwig DJ, Thirlby RC, Low DE. A prospective evaluation of dietary status and symptoms after near-total esophagectomy without gastric emptying procedure. Am J Surg. 2001;181(5):454–458.

 Web of Science ®Google Scholar

McLarty AJ, Deschamps C, Trastek VF, Allen MS, Pairolero PC, Harmsen WS. Esophageal resection for cancer of the esophagus: long-term function and quality of life. Ann Thorac Surg. 1997;63(6):1568–1572.

 PubMed Web of Science ®Google Scholar

Finley RJ, Lamy A, Clifton J, Evans KG, Fradet G, Nelems B. Gastrointestinal function following esophagectomy for malignancy. Am J Surg. 1995;169(5):471–475.

 Web of Science ®Google Scholar

Ginex P, Thom B, Jingeleski M, et al. Patterns of symptoms following surgery for esophageal cancer. Oncol Nurs Forum. 2013;40(3):E101–E107.

 Google Scholar