Learning curve of non-tube and early oral feeding after McKeown minimally invasive esophagectomy
10.7507/1007-4848.201810041
- VernacularTitle:微创食管癌切除术“免管免禁”快速康复学习过程分析
- Author:
LIU Baoxing
1
;
MA Haibo
1
;
LI Yin
2
,
3
;
QIN Jianjun
2
,
3
;
ZHANG Ruixiang
1
;
LIU Xianben
1
;
XING Wenqun
1
Author Information
1. Department of Thoracic Surgery, The Affiliated Tumor Hospital, Zhengzhou University, Zhengzhou, 450008, P.R.China
2. 1. Department of Thoracic Surgery, The Affiliated Tumor Hospital, Zhengzhou University, Zhengzhou, 450008, P.R.China
3. 2. Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, P.R.China
- Publication Type:Journal Article
- Keywords:
Esophageal cancer;
minimally invasive esophagectomy (MIE);
enhanced recovery after surgery;
non-tube and early oral feeding
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(7):642-647
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the learning curve of non-tube and early oral feeding procedure following McKeown minimally invasive esophagectomy (MIE). Methods We analyzed the clinical data of 38 patients (26 males, 12 females, aged 42–79 years) with esophageal cancer who received non-tube and early oral feeding procedure after surgery at the Affiliated Tumor Hospital, Zhengzhou University from November 2017 to August 2018. They suffered upper thoracic esophageal cancer (n=4), middle thoracic esophageal cancer (n=22) or lower thoracic esophageal cancer (n=12). Results McKeown MIE was successfully performed on 38 patients. Oral feeding began 1.7 (1-4) days after surgery in the 38 patients with non-tube. Pneumonia/atelectasis occurred in 5 patients (13.1%), respiratory failure in 1 patient (2.6%), arrhythmia in 3 patients (7.9%), hoarseness in 5 patients (13.1%), anastomotic fistula in 1 patient (2.6%), cervical incision infection in 1 patient (2.6%), pneumomediastinum and infection in 1 patient (2.6%) and gastric emptying disorder in 2 patients (5.2%). No death was observed. After 26 patients with McKeown MIE were treated with enhanced recovery after surgery procedure, the operation time and complications could reach a relatively stable state and entered a plateau phase of learning curve. Conclusion Non-tube and early oral feeding procedure following MIE is technically safe and feasible. It can shorten hospital stay, relieve the discomfort of placement of nasogastric and nutrition tube and may reduce the incidence of complications. The learning curve of non-tube and early oral feeding procedure following MIE is about 26 cases.
