Retrograde gastric decompression and anterograde enteral nutrition feeding in retrosternal esophagectomy for esophageal cancer.

BACKGROUND

Postoperative care after McKeown esophagectomy remains challenging. The aim of this study was to evaluate retrograde gastric decompression and feeding as an alternative to nasogastric decompression and nasogastric-jejunal feeding.

METHODS

This retrospective study analyzed 142 esophageal cancer patients undergoing McKeown esophagectomy (between June 2020 and August 2022): retrograde gastric decompression and feeding (n=74) vs. nasogastric-jejunal (n=68). Outcomes included operative parameters, complications, and recovery metrics.

RESULTS

Retrograde gastric decompression and feeding required longer operative time (183.0±41.7 vs. 169.4±32.6 min, p=0.031) but showed comparable blood loss, R0 resection rates (95.9 vs. 97.1%), and lymph node yield. Gastric tube retention was shorter with retrograde gastric decompression and feeding (3.2±1.6 vs. 3.6±1.4 days). Complication rates (anastomotic leak: 10.8 vs. 10.3%; respiratory: 16.2 vs. 16.2%) and in-hospital mortality (1.4 vs. 1.5%) were similar. Tube-related complications trended lower with retrograde gastric decompression and feeding (5.4 vs. 10.3%, p=0.276).

CONCLUSION

Retrograde gastric decompression and feeding is a safe, effective method for enteral nutrition and decompression post-esophagectomy.