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

## TL;DR

This study compares two post-surgery methods after esophagectomy for cancer and finds retrograde gastric decompression and feeding to be safe and effective.

## Contribution

The study introduces retrograde gastric decompression and feeding as a viable alternative to traditional nasogastric methods after esophagectomy.

## Key findings

- Retrograde gastric decompression and feeding had comparable complication rates and shorter gastric tube retention.
- Operative time was longer with retrograde gastric decompression and feeding, but blood loss and R0 resection rates were similar.
- Tube-related complications trended lower with retrograde gastric decompression and feeding, though not statistically significant.

## Abstract

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.

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.

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).

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