[Early postoperative enteral feeding following esophageal resection]

In a prospective randomized study, total parenteral alimentation was compared with early postoperative enteral alimentation in a group of patients who had undergone esophageal resection. In addition to mechanical problems with the jejunal catheter abdominal complications arose during enteral alimentation (meteorism, distension), leading to discontinuation in one-third of cases. The limited prognostic value of ultrasound examination of the abdomen - now often used postoperatively as a decisive aid to diagnosis - is a further serious disadvantage; overall, since there are no particulars in which enteral alimentation can be shown to be superior to parenteral alimentation, it no longer seems justified in the early postoperative phase. The jejunal catheter has, however, proved its worth as a means of direct access to the intestine that can be exploited any time after the initial postoperative period (a week to some months after surgery). For this reason we now insert a jejunal catheter routinely following esophagectomy or gastrectomy.