Safety and feasibility of early oral feeding following hand-sewn cervical esophagogastric anastomosis in ESCC.

BACKGROUND

This study evaluated the safety and feasibility of early oral feeding (EOF) after cervical hand-sewn esophagogastric anastomosis in minimally invasive esophagectomy for esophageal squamous cell carcinoma (ESCC).

RESEARCH DESIGN AND

METHODS

We retrospectively analyzed 80 ESCC patients undergoing thoracoscopic-laparoscopic esophagectomy (2020-2024). Based on anastomotic technique and feeding timing, patients were divided into hand-sewn (EOF on postoperative day 1) and mechanical anastomosis groups (oral feeding on days 7-9). Outcomes included operative parameters, complications, and recovery indicators.

RESULTS

The hand-sewn group demonstrated longer duration of operation (450 vs. 390 min) but superior outcomes: less blood loss (80 vs. 100 mL), shorter hospitalization (11 vs. 16.5 days), lower pain scores (3 vs. 7), and faster gastrointestinal recovery (3 vs. 5 days) (all p < 0.001). Complication rates were significantly lower for anastomotic leakage (5.0% vs. 20.0%), pulmonary infection (17.5% vs. 42.5%), and pleural effusion (40.0% vs. 67.5%) (all p < 0.05). No differences were found in chylothorax or anastomotic stricture.

CONCLUSION

Early oral feeding following hand-sewn cervical anastomosis is safe and feasible in selected ESCC patients, promoting faster recovery with fewer complications, and should be incorporated into enhanced recovery protocols.