Abstract
Standard nasogastric decompression following esophagectomy is associated with reduced patient comfort and mobility and impaired hypopharyngeal function-predisposing the patient to sinusitis, pharyngitis, and the risk of aspiration. In this study, we evaluate the results of the transcervical gastric tube drainage in the setting of esophagectomy. Transcervical gastric tube decompression was performed on 145 consecutive patients undergoing open esophagectomy between 2003 and 2007. Postoperative outcome variables include morbidity, mortality, esophagostomy duration, and length of stay. There were 107 males and 38 females (median age∈=∈66; range∈=∈37-87). Perioperative mortality was 2.8%. Major complications included five anastomotic leaks (3.4%), ten pneumonias (6.9%), two myocardial infarctions (1.4%), and the need for reoperation in four patients (bleeding, dehiscence). Median duration of transcervical drainage was 8 days. No tubes were dislodged prematurely. There were no bleeding complications. Four patients developed cellulitis near the cervical gastric tube site and were treated successfully with antibiotics and/or tube removal. Transcervical gastric decompression can be performed safely with minimal complication risk. Inadvertent tube removal was not encountered in this series. The use of this technique may help to promote accelerated patient mobilization, greater patient comfort, and a durable means of gastric decompression.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1479-1484 |
| Number of pages | 6 |
| Journal | Journal of Gastrointestinal Surgery |
| Volume | 12 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2008 |
| Externally published | Yes |
Fingerprint
Keywords
- Anastomotic leak
- Cervical esophagostomy
- Esophagectomy
- Gastric decompression
- Ischemia
ASJC Scopus subject areas
- Surgery
Cite this
Transcervical gastric tube drainage facilitates patient mobility and reduces the risk of pulmonary complications after esophagectomy. / Schuchert, Matthew J.; Pettiford, Brian L.; Landreneau, Joshua P.; Waxman, Jonathon; Kilic, Arman; Santos, Ricardo S.; Kent, Michael S.; El-Sherif, Amgad; Abbas, Ghulam; Luketich, James D.; Landreneau, Rodney J.
In: Journal of Gastrointestinal Surgery, Vol. 12, No. 9, 09.2008, p. 1479-1484.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Transcervical gastric tube drainage facilitates patient mobility and reduces the risk of pulmonary complications after esophagectomy
AU - Schuchert, Matthew J.
AU - Pettiford, Brian L.
AU - Landreneau, Joshua P.
AU - Waxman, Jonathon
AU - Kilic, Arman
AU - Santos, Ricardo S.
AU - Kent, Michael S.
AU - El-Sherif, Amgad
AU - Abbas, Ghulam
AU - Luketich, James D.
AU - Landreneau, Rodney J.
PY - 2008/9
Y1 - 2008/9
N2 - Standard nasogastric decompression following esophagectomy is associated with reduced patient comfort and mobility and impaired hypopharyngeal function-predisposing the patient to sinusitis, pharyngitis, and the risk of aspiration. In this study, we evaluate the results of the transcervical gastric tube drainage in the setting of esophagectomy. Transcervical gastric tube decompression was performed on 145 consecutive patients undergoing open esophagectomy between 2003 and 2007. Postoperative outcome variables include morbidity, mortality, esophagostomy duration, and length of stay. There were 107 males and 38 females (median age∈=∈66; range∈=∈37-87). Perioperative mortality was 2.8%. Major complications included five anastomotic leaks (3.4%), ten pneumonias (6.9%), two myocardial infarctions (1.4%), and the need for reoperation in four patients (bleeding, dehiscence). Median duration of transcervical drainage was 8 days. No tubes were dislodged prematurely. There were no bleeding complications. Four patients developed cellulitis near the cervical gastric tube site and were treated successfully with antibiotics and/or tube removal. Transcervical gastric decompression can be performed safely with minimal complication risk. Inadvertent tube removal was not encountered in this series. The use of this technique may help to promote accelerated patient mobilization, greater patient comfort, and a durable means of gastric decompression.
AB - Standard nasogastric decompression following esophagectomy is associated with reduced patient comfort and mobility and impaired hypopharyngeal function-predisposing the patient to sinusitis, pharyngitis, and the risk of aspiration. In this study, we evaluate the results of the transcervical gastric tube drainage in the setting of esophagectomy. Transcervical gastric tube decompression was performed on 145 consecutive patients undergoing open esophagectomy between 2003 and 2007. Postoperative outcome variables include morbidity, mortality, esophagostomy duration, and length of stay. There were 107 males and 38 females (median age∈=∈66; range∈=∈37-87). Perioperative mortality was 2.8%. Major complications included five anastomotic leaks (3.4%), ten pneumonias (6.9%), two myocardial infarctions (1.4%), and the need for reoperation in four patients (bleeding, dehiscence). Median duration of transcervical drainage was 8 days. No tubes were dislodged prematurely. There were no bleeding complications. Four patients developed cellulitis near the cervical gastric tube site and were treated successfully with antibiotics and/or tube removal. Transcervical gastric decompression can be performed safely with minimal complication risk. Inadvertent tube removal was not encountered in this series. The use of this technique may help to promote accelerated patient mobilization, greater patient comfort, and a durable means of gastric decompression.
KW - Anastomotic leak
KW - Cervical esophagostomy
KW - Esophagectomy
KW - Gastric decompression
KW - Ischemia
UR - http://www.scopus.com/inward/record.url?scp=49749084705&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=49749084705&partnerID=8YFLogxK
U2 - 10.1007/s11605-008-0541-8
DO - 10.1007/s11605-008-0541-8
M3 - Article
C2 - 18560944
AN - SCOPUS:49749084705
VL - 12
SP - 1479
EP - 1484
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
SN - 1091-255X
IS - 9
ER -