1Department of Thoracic Surgery， The First Affiliated Hospital of Zhejiang University， Hangzhou 310003， Zhejiang， China； 2Department of Medical Engineering， The First Affiliated Hospital of Zhejiang University， Hangzhou 310003， Zhejiang， China； 3Department of Operation Room， The First Affiliated Hospital of Zhejiang University， Hangzhou 310003， Zhejiang， China
Abstract Objective To summarize clinical application and experience of abdominal retrograde gastric and jejunal feeding tube and study its clinical value. Methods We viewed 45 adult patients with esophageal carcinoma treated with two-incision esophagectomy from January 1st， 2014 to December 31th， 2016 in Department of Thoracic Surgery， the First Affiliated Hospital of Zhejiang University. During the surgeries， 31 patients were treated with nasogastric tube and jejunostomy tube (control group)， and 14 patients were treated with retrograde gastric tube and jejunostomy tube (abdominal retrograde gastric and jejunal feeding tube， experimental group). All of them were diagnosed with esophageal squamous cancer according to the postoperative pathological results. Results Differences of general information between two groups including gender， age， body mass index， smoking history， preoperative albumin， preoperative alanine aminotransferase， preoperative aspartate aminotransferase， preoperative hemoglobin， location and pathological TNM stage were not statistically significant (P>0.05). Operative time， operative blood loss， postoperative albumin， postoperative hemoglobin， duration of using gastric tube， length of postoperative stay and complication rate between the two groups were not statistically different (P>0.05). The experimental group had less postoperative drainage volume of gastric tube in 24h (P＜0.05). Conclusion For resectable esophageal carcinoma， abdominal retrograde gastric and jejunal feeding tube can provide effective gastrointestinal decompression and enteral nutrition while avoiding nasal irritation and inconvenience. So it deserves to be further studied and widely applied.
ZHANG Chong,CAO Long-xiang,LV Ying-ying, et al. Clinical application and research of abdominal retrograde gastric and jejunal feeding tube[J]. Electron J Metab Nutr Cancer, 2019, 6(2): 206-211.
1.Ajani JA， D’Amico TA， Almhanna K， et al. Esophageal and esophagogastric junction cancers， version 1.2015. J Natl Compr Canc Netw. 2015；13(2):194-227.
2.陈万青， 郑荣寿，曾红梅，等. 2011年中国恶性肿瘤发病和死亡分析. 中国肿瘤. 2016；25(1):1-8.
3.Hategan M， Cook N， Prewett S， et al. Trimodality therapy and definitive chemoradiotherapy for esophageal cancer: a single-center experience and review of the literature. Dis Esophagus. 2015；28(7):612-618.
4.Rice TW， Rusch VW， Ishwaran H， et al. Cancer of the esophagus and esophagogastric junction: data-driven staging for the seventh edition of the American Joint Committee on Cancer/International Union Against Cancer Cancer Staging Manuals. Cancer. 2010；116(16):3763-3773.
5.陈孝平， 汪建平. 外科学(第8版). 北京: 人民卫生出版社，2013.
6.Yasuda M， Saeki H， Nakashima Y， et al. Treatment results of two-stage operation for the patients with esophageal cancer concomitant with liver dysfunction.J Med Invest. 2015；62(3-4):149-153.
7.Samples JE， Snavely AC， Meyers MO. Postoperative morbidity in curative resection of Gastroesophageal Carcinoma does not impact long-term survival.Am Surg. 2015；81(12):1228-1231.
8.Alldinger I， Sisic L， Hochreiter M， et al.Outcome， complications， and mortality of an intrathoracic anastomosis in esophageal cancer in patients without a preoperative selection with a risk score. Langenbecks Arch Surg. 2015；400(1):9-18.
9.Licht E， Markowitz AJ， Bains MS， et al. Endoscopic management of esophageal anastomotic leaks after surgery for malignant disease. Ann Thorac Surg. 2016；101(1):301-304.
10.张毅， 潘铁成， 魏翔. 胸腹腔镜联合食管癌根治手术图谱. 武汉: 华中科技大学出版社， 2013.
11.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.
12.韩毓， 曲兴龙， 傅红.胃癌手术无胃肠减压的安全性及意义. 世界华人消化杂志.2014；(27):4075-4080.
13.陈钶， 牟一平， 徐晓武， 等. 胃癌根治术后常规留置胃管必要性的荟萃分析. 中华医学杂志. 2012； 92(26):1841-1844.
14.于雪峰， 魏玉哲， 薛英威. 留置胃管对胃癌患者围手术期生活质量的影响.中华胃肠外科杂志. 2012；15(6):578-580.
15.Bauer VP.The evidence against prophylactic nasogastric intubation and oral restriction. Clin Colon Rectal Surg. 2013；26(3):182-185.
16.Nguyen NT， Slone J， Wooldridge J， et al. Minimally invasive esophagectomy without the use of postoperative nasogastric tube decompression. Am Surg. 2009；75(10):929-931.
17.孙海波， 李印， 刘先本，等.食管癌微创手术后不放胃管不禁食的可行性研究. 中华胃肠外科杂志. 2014；(9):898-901.
18.Mistry RC， Vijayabhaskar R， Karimundackal G， et al. Effect of short-term vs prolonged nasogastric decompression on major postesophagectomy complications: a parallel-group， randomized trial. Arch Surg. 2012；147(8):747-751.
19.王总飞， 张瑞祥， 刘先本，等. 不常规经鼻胃肠减压在食管癌腔镜手术中应用的可行性研究. 中国胸心血管外科临床杂志. 2014；(4):494-497.
20.Daryaei P， Vaghef Davari F， Mir M， et al. Omission of nasogastric tube application in postoperative care of esophagectomy. World J Surg. 2009；33(4):773-777.
21.Shackcloth MJ， McCarron E， Kendall J， et al. Randomized clinical trial to determine the effect of nasogastric drainage on tracheal acid aspiration following oesophagectomy.Br J Surg. 2006；93(10):1305.
22.Nelson R， Edwards S， Tse B. Prophylactic nasogastric decompression after abdominal surgery. Cochrane Database Syst Rev. 2007；(3):CD004929.
23.Schuchert MJ， Pettiford BL， Landreneau JP， et al. Transcervical gastric tube drainage facilitates patient mobility and reduces the risk of pulmonary complications after esophagectomy. J Gastrointest Surg. 2008；12(9):1479-1484.
24.Joshi N， Localio AR， Hamory BH. A predictive risk index for nosocomial pneumonia in the intensive care unit. Am J Med. 1992；93(2):135-142.
25.Cheatham ML， Chapman WC， Key SP et al. A meta-analysis of selective versus routine nasogastric decompression after elective laparotomy.Ann Surg. 1995；221(5):469-476.
26.Rueth NM， Lee N， Groth SS， et al. Pharyngostomy tubes for gastric conduit decompression. J Thorac Cardiovasc Surg. 2010；140(2):373-376.
27.周林秋， 虞立平， 戴国芳，等. 老年胃癌手术患者不同途径留置胃肠减压-肠内营养管效果的分析. 齐齐哈尔医学院学报. 2014；35(21):3195-3196.
28.梁宜武， 赵克明， 曾繁文. 胸腔引流、空肠逆行置胃管及空肠造瘘治疗食管胃吻合口瘘. 武警医学. 1999；10(1):13-14.
29.马千里， 王建军， 汪文东，等. 逆行胃肠减压成功救治自发性食管破裂1例. 华中医学杂志. 2006；30(3):230.
30.Puri V， Hu Y， Guthrie T， et al. Retrograde jejunogastric decompression after esophagectomy is superior to nasogastric drainage.Ann Thorac Surg. 2011；92(2):499-503.
31.Chirica M， Kraemer A， Petrascu E， et al. Esophagojejunostomy after total gastrectomy for caustic injuries. Dis Esophagus. 2014；27(2):122-127.
32.Urschel JD， Antkowiak JG， Anderson TM， et al. Retrograde jejunogastric tube decompression after esophagectomy.J Surgical Oncol. 1998；68(3):204-205.
33.Zhang M， Wu QC， Li Q， et al. Comparison of the health-related quality of life in patients with narrow gastric tube and whole stomach reconstruction after oncologic esophagectomy: a prospective randomized study.Scand J Surg. 2013；102(2):77-82.
34.Liu CQ， Xie MR， Guo MF， et al. Short-term outcomes of minimally invasive sweet esophagectomy for siewert type Ⅱ esophagogastric junction adenocarcinoma. Chinese J Surg. 2016；54(6):461-465.
35.Ito H， Inoue H， Odaka N， et al. Evaluation of the safety and efficacy of esophagojejunostomy after totally laparoscopic total gastrectomy using a trans-orally inserted anvil: a single-center comparative study. Surg Endosc. 2014；28(6):1929-1935.
36.Hiyoshi Y， Oki E， Ando K， et al. Outcome of esophagojejunostomy during totally laparoscopic total gastrectomy: a single-center retrospective study. Anticancer Res. 2014；34(12):7227-7232.
37.Kim SH， Lee KS， Shim YM， et al.Esophageal resection: indications， techniques， and radiologic assessment. Radiographics. 2001；21(5):1119-1137.
38.Shen CY， Chen HN， Zhang B， et al. Quality of life of patients with gastric tube anastomosis after proximal gastrectomy in adenocarcinoma of esophagogastric junction. Sichuan da xue xue bao Yi xue ban. 2014；45(4):717-719，723.
