Safety and cost-benefit analysis of patients without gastric tube after thoracolaparoscopic esophagectomy: A prospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YIN Yuanyuan ¹ , ZHENG E ¹ , LI Huanhuan ² ,  YANG Mei ¹ , YAO Li ¹ , ZHAO Chunlin ¹

1. West China School of Nursing, Sichuan University, Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610000, P. R. China;
2. West China School of Nursing, Sichuan University, Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610000,P. R. China;

Corresponding author：

YANG Mei, Email: yangmei69@126.com

Keywords：

Thoracolaparoscopy; esophageal cancer surgery; indwelling gastric tube; cost-benefit

DOI：

10.7507/1007-4848.202209063

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the safety and comfort of patients with or without postoperative gastric tube placement after esophageal cancer surgery, and analyze the cost and nursing time of gastric tube placement. Methods The patients with esophageal cancer undergoing minimally invasive surgery in West China Hospital of Sichuan University in 2021 were enrolled. The patients were divided into a gastric tube indwelling group and a non gastric tube indwelling group according to whether the gastric tube was indwelled after the operation. The safety and comfort indicators of the two groups were compared. Results A total of 130 patients were enrolled. There were 66 patients in the gastric tube indwelling group, including 53 males and 13 females, aged 61.80±9.05 years and 64 patients in the non gastric tube indwelling group, including 55 males and 9 females, aged 64.47±8.00 years. Six patients in the non gastric tube indwelling group needed to place gastric tube 1 to 3 days after the operation due to their condition. There was no statistical difference in the incidence of postoperative complications between the two groups (P>0.05). The subjective comfort of patients in the gastric tube indwelling group was significantly lower than that in the non gastric tube indwelling group (P<0.001), and the incidence of foreign body sensation in the throat of patients in the gastric tube indwelling group was higher than that in the non gastric tube indwelling group (P<0.001). The average nursing time in the gastric tube indwelling group was about 59.58 minutes, and the average cost of gastric tube materials and nursing was 378.24 yuan per patient. Conclusion No gastric tube used after operation for appropriate esophageal cancer patients will not increase the incidence of postoperative complications (pulmonary infection, anastomotic leakage, chylothorax), but can increase the comfort of patients, save cost and reduce nursing workload, which is safe, feasible and economical.

Citation： YIN Yuanyuan, ZHENG E, LI Huanhuan, YANG Mei, YAO Li, ZHAO Chunlin. Safety and cost-benefit analysis of patients without gastric tube after thoracolaparoscopic esophagectomy: A prospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(5): 728-732. doi: 10.7507/1007-4848.202209063 Copy

1.	刘宗超, 李哲轩, 张阳, 等. 2020全球癌症统计报告解读. 肿瘤综合治疗电子杂志, 2021, 7(2): 1-13.
2.	Thrift AP, Whiteman DC. The incidence of esophageal adenocarcinoma continues to rise: Analysis of period and birth cohort effects on recent trends. Ann Oncol, 2012, 23(12): 3155-3162.
3.	刘宇英, 魏君丽, 江柔, 等. 食管癌的流行病学及筛查研究进展. 中华疾病控制杂志, 2022, 26(7): 839-844.
4.	唐德荣, 嵇建, 王前伟, 等. 胸腹腔镜食管癌根治术后放置胃管和无胃管对并发症的影响. 临床外科杂志, 2021, 29(6): 538-541.
5.	Mangano A, Marciano L. One-day nasogastric tube decompression after distal gastrectomy: A prospective randomized study. Surg Today, 2018, 48(1): 127.
6.	Gaignard E, Bergeat D, Courtin-Tanguy L, et al. Is systematic nasogastric decompression after pancreaticoduodenectomy really necessary? Langenbecks Arch Surg, 2018, 403(5): 573-580.
7.	中华人民共和国卫生部. 医院感染诊断标准(试行). 现代实用医学, 2003, 15(7): 460-465.
8.	Smeets BJJ, Luyer MDP. Nutritional interventions to improve recovery from postoperative ileus. Curr Opin Clin Nutr Metab Care, 2018, 21(5): 394-398.
9.	Weijs TJ, Kumagai K, Berkelmans GH, et al. Nasogastric decompression following esophagectomy: A systematic literature review and meta-analysis. Dis Esophagus, 2017, 30(3): 1-8.
10.	Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: A review. JAMA Surg, 2017, 152(3): 292-298.
11.	李印. "免管免禁"食管癌外科模式的历史、现状与未来. 中华胸部外科电子杂志, 2020, 7(3): 135-139.
12.	Li Y, Liu Z, Liu G, et al. Impact on short-term complications of early oral feeding in patients with esophageal cancer after esophagectomy. Nutr Cancer, 2021, 73(4): 609-616.
13.	Sato T, Takayama T, So K, et al. Is retention of a nasogastric tube after esophagectomy a risk factor for postoperative respiratory tract infection? J Infect Chemother, 2007, 13(2): 109-113.
14.	杨璐霄, 何亮, 张加鑫, 等. 腹腔镜辅助胃癌根治术不留置胃管临床研究. 中国实用外科杂志, 2020, 40(4): 461-464.
15.	孟祥宁. 腹腔镜辅助胃癌根治术不留置胃管对缩短术后住院时间及降低肺部并发症发生率影响研究. 中国全科医学, 2021, 24(S1): 46-48.
16.	Jordan EA, Moore SC. Enteral nutrition in critically ill adults: Literature review of protocols. Nurs Crit Care, 2020, 25(1): 24-30.
17.	Sakaguchi T, Hirata A, Kashiwase K, et al. Relationship of central venous pressure to body fluid volume status and its prognostic implication in patients with acute decompensated heart failure. J Card Fail, 2020, 26(1): 15-23.
18.	陈煌, 邓小玲, 李秋燕, 等. 住院病人非计划性拔管风险评估体系的构建. 护理研究, 2019, 33(14): 2404-2409.
19.	夏云, 杨莹, 徐佳英, 等. 留置鼻胆管患者非计划性拔管的影响因素分析. 中华现代护理杂志, 2019, 25(27): 3501-3504.
20.	Di Palma LDV, Mello GFSE, Granados CL, et al. Pharyngocutaneous fistula as an alternative access route for inserting a percutaneous endoscopic gastrostomy tube in head and neck cancer patients. Endosc Int Open, 2017, 5(7): E630-E634.
21.	Sakatoku Y, Fukaya M, Fujieda H, et al. Tracheoesophageal fistula after total resection of gastric conduit for gastro-aortic fistula due to gastric ulcer. Surg Case Rep, 2017, 3(1): 90.
22.	吴茜, 周姝, 万文洁, 等. 留置鼻胆管对患者生理舒适度的影响和相关因素分析. 中华护理杂志, 2012, 47(11): 1017-1019.
23.	金环, 夏家红, 杨晓霞, 等. 患者安全目标: 管路安全影响因素与管理策略. 中国卫生质量管理, 2020, 27(6): 9-12.
24.	肖鑫, 栾思源, 杨玉赏, 等. 锥形管状胃联合颈部端端分层吻合在胸腹腔镜食管癌切除术中的应用价值. 中华消化外科杂志, 2019, 18(6): 542-548.

1. 刘宗超, 李哲轩, 张阳, 等. 2020全球癌症统计报告解读. 肿瘤综合治疗电子杂志, 2021, 7(2): 1-13.
2. Thrift AP, Whiteman DC. The incidence of esophageal adenocarcinoma continues to rise: Analysis of period and birth cohort effects on recent trends. Ann Oncol, 2012, 23(12): 3155-3162.
3. 刘宇英, 魏君丽, 江柔, 等. 食管癌的流行病学及筛查研究进展. 中华疾病控制杂志, 2022, 26(7): 839-844.
4. 唐德荣, 嵇建, 王前伟, 等. 胸腹腔镜食管癌根治术后放置胃管和无胃管对并发症的影响. 临床外科杂志, 2021, 29(6): 538-541.
5. Mangano A, Marciano L. One-day nasogastric tube decompression after distal gastrectomy: A prospective randomized study. Surg Today, 2018, 48(1): 127.
6. Gaignard E, Bergeat D, Courtin-Tanguy L, et al. Is systematic nasogastric decompression after pancreaticoduodenectomy really necessary? Langenbecks Arch Surg, 2018, 403(5): 573-580.
7. 中华人民共和国卫生部. 医院感染诊断标准(试行). 现代实用医学, 2003, 15(7): 460-465.
8. Smeets BJJ, Luyer MDP. Nutritional interventions to improve recovery from postoperative ileus. Curr Opin Clin Nutr Metab Care, 2018, 21(5): 394-398.
9. Weijs TJ, Kumagai K, Berkelmans GH, et al. Nasogastric decompression following esophagectomy: A systematic literature review and meta-analysis. Dis Esophagus, 2017, 30(3): 1-8.
10. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: A review. JAMA Surg, 2017, 152(3): 292-298.
11. 李印. "免管免禁"食管癌外科模式的历史、现状与未来. 中华胸部外科电子杂志, 2020, 7(3): 135-139.
12. Li Y, Liu Z, Liu G, et al. Impact on short-term complications of early oral feeding in patients with esophageal cancer after esophagectomy. Nutr Cancer, 2021, 73(4): 609-616.
13. Sato T, Takayama T, So K, et al. Is retention of a nasogastric tube after esophagectomy a risk factor for postoperative respiratory tract infection? J Infect Chemother, 2007, 13(2): 109-113.
14. 杨璐霄, 何亮, 张加鑫, 等. 腹腔镜辅助胃癌根治术不留置胃管临床研究. 中国实用外科杂志, 2020, 40(4): 461-464.
15. 孟祥宁. 腹腔镜辅助胃癌根治术不留置胃管对缩短术后住院时间及降低肺部并发症发生率影响研究. 中国全科医学, 2021, 24(S1): 46-48.
16. Jordan EA, Moore SC. Enteral nutrition in critically ill adults: Literature review of protocols. Nurs Crit Care, 2020, 25(1): 24-30.
17. Sakaguchi T, Hirata A, Kashiwase K, et al. Relationship of central venous pressure to body fluid volume status and its prognostic implication in patients with acute decompensated heart failure. J Card Fail, 2020, 26(1): 15-23.
18. 陈煌, 邓小玲, 李秋燕, 等. 住院病人非计划性拔管风险评估体系的构建. 护理研究, 2019, 33(14): 2404-2409.
19. 夏云, 杨莹, 徐佳英, 等. 留置鼻胆管患者非计划性拔管的影响因素分析. 中华现代护理杂志, 2019, 25(27): 3501-3504.
20. Di Palma LDV, Mello GFSE, Granados CL, et al. Pharyngocutaneous fistula as an alternative access route for inserting a percutaneous endoscopic gastrostomy tube in head and neck cancer patients. Endosc Int Open, 2017, 5(7): E630-E634.
21. Sakatoku Y, Fukaya M, Fujieda H, et al. Tracheoesophageal fistula after total resection of gastric conduit for gastro-aortic fistula due to gastric ulcer. Surg Case Rep, 2017, 3(1): 90.
22. 吴茜, 周姝, 万文洁, 等. 留置鼻胆管对患者生理舒适度的影响和相关因素分析. 中华护理杂志, 2012, 47(11): 1017-1019.
23. 金环, 夏家红, 杨晓霞, 等. 患者安全目标: 管路安全影响因素与管理策略. 中国卫生质量管理, 2020, 27(6): 9-12.
24. 肖鑫, 栾思源, 杨玉赏, 等. 锥形管状胃联合颈部端端分层吻合在胸腹腔镜食管癌切除术中的应用价值. 中华消化外科杂志, 2019, 18(6): 542-548.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Safety and cost-benefit analysis of patients without gastric tube after thoracolaparoscopic esophagectomy: A prospective cohort study

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content