Transcervical gastric tube drainage facilitates patient mobility and reduces the risk of pulmonary complications after esophagectomy

Matthew J. Schuchert, Brian L. Pettiford, Joshua P. Landreneau, Jonathon Waxman, Arman Kilic, Ricardo S. Santos, Michael S. Kent, Amgad El-Sherif, Ghulam Abbas, James D. Luketich, Rodney J. Landreneau

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)1479-1484
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume12
Issue number9
DOIs
StatePublished - Sep 2008
Externally publishedYes

Fingerprint

Esophagectomy
Drainage
Stomach
Decompression
Lung
Esophagostomy
Hemorrhage
Anastomotic Leak
Cellulitis
Pharyngitis
Mortality
Sinusitis
Reoperation
Length of Stay
Pneumonia
Myocardial Infarction
Anti-Bacterial Agents
Morbidity

Keywords

  • Anastomotic leak
  • Cervical esophagostomy
  • Esophagectomy
  • Gastric decompression
  • Ischemia

ASJC Scopus subject areas

  • Surgery

Cite this

Schuchert, M. J., Pettiford, B. L., Landreneau, J. P., Waxman, J., Kilic, A., Santos, R. S., ... Landreneau, R. J. (2008). Transcervical gastric tube drainage facilitates patient mobility and reduces the risk of pulmonary complications after esophagectomy. Journal of Gastrointestinal Surgery, 12(9), 1479-1484. https://doi.org/10.1007/s11605-008-0541-8

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 journalArticle

Schuchert, MJ, Pettiford, BL, Landreneau, JP, Waxman, J, Kilic, A, Santos, RS, Kent, MS, El-Sherif, A, Abbas, G, Luketich, JD & Landreneau, RJ 2008, 'Transcervical gastric tube drainage facilitates patient mobility and reduces the risk of pulmonary complications after esophagectomy', Journal of Gastrointestinal Surgery, vol. 12, no. 9, pp. 1479-1484. https://doi.org/10.1007/s11605-008-0541-8
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. / Transcervical gastric tube drainage facilitates patient mobility and reduces the risk of pulmonary complications after esophagectomy. In: Journal of Gastrointestinal Surgery. 2008 ; Vol. 12, No. 9. pp. 1479-1484.
@article{b3cc747f49c54a579496fdd7619d2e9a,
title = "Transcervical gastric tube drainage facilitates patient mobility and reduces the risk of pulmonary complications after esophagectomy",
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.",
keywords = "Anastomotic leak, Cervical esophagostomy, Esophagectomy, Gastric decompression, Ischemia",
author = "Schuchert, {Matthew J.} and Pettiford, {Brian L.} and Landreneau, {Joshua P.} and Jonathon Waxman and Arman Kilic and Santos, {Ricardo S.} and Kent, {Michael S.} and Amgad El-Sherif and Ghulam Abbas and Luketich, {James D.} and Landreneau, {Rodney J.}",
year = "2008",
month = "9",
doi = "10.1007/s11605-008-0541-8",
language = "English (US)",
volume = "12",
pages = "1479--1484",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",
number = "9",

}

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 -