OBJECTIVETo investigate the feasibility of no nasogastric intubation and early oral feeding at will after thoracolaparoscopic esophagectomy for patients with esophageal cancer.

METHODSBetween January 2013 and January 2014, the feasibility of no nasogastric intubation and early oral feeding at postoperative day(POD) 1 after thoracolaparoscopic esophagectomy was prospectively investigated in 156 patients (trial group) with esophageal cancer in the Henan Cancer Hospital. One hundred and sixty patients previously managed in the same unit who were treated routinely after thoracolaparoscopic esophagectomy were served as control group.

RESULTSOf 156 patients of trial group, 6(3.8%) patients could not take food early as planned because of postoperative complications. The overall complication rate in trial group was 19.2%(30/156), which was 25.0%(30/160) in control group (P=0.217). The anastomotic leakage in trial group and control group was 2.6%(4/156) and 4.3%(7/160) respectively (P=0.380). Compared with control group, time to first flatus [(2.1±0.9) d vs. (3.3±1.1) d, P<0.001], bowel movement [(4.4±1.3) d vs. (6.6±1.0) d, P<0.001] and postoperative hospital stay [(8.3±3.2) d vs. (10.4±3.6) d, P<0.001] were significantly shorter in trial group.

CONCLUSIONSNo nasogastric intubation and early oral feeding postoperatively in patients with thoracolaparoscopic esophagectomy is feasible and safe. This management can shorten postoperative hospital stay and fasten postoperative bowel function recovery.

Eating ; Esophageal Neoplasms ; surgery ; Esophagectomy ; Fasting ; Feasibility Studies ; Humans ; Intubation, Gastrointestinal ; Postoperative Complications ; Postoperative Period

Objective　 To explore the clinical features,diagnosis and treatment status of serotonin syndrome (SS) in China by analyzing the case report of serotonin syndrome.Methods　We studied all case report of serotonin syndrome by database retrieval.The clinical features,treatment and outcome were analyzed statistically.Results　A total of 41 patients with serotonin syndrome were collected,the most common clinical features were the increase of blood pressure or heart rate (97.6%),sweating (92.7%),tremor (80.5%),Secondly were myoclonus or myotonia (73.2%),fever (58.6%),agitation or delirium (61%),and disturbance of consciousness (58.5%).Conclusion　Selective 5-hydroxytryptamine reuptake inhibitors are still the most common drugs leading to serotonin syndrome.The most common features were autonomic nervous system disorders,followed by neuromuscular symptoms,mental or consciousness changes.At present,the prevention and diagnosis of serotonin syndrome have not been given enough attention in our country.Early detection and early intervention have a positive effect on reducing the clinical adverse outcome.