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Updated: Oct 15, 2025

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Protein-enhanced feeds after esophagectomy for esophageal cancer attenuate postoperative catabolism: a prospective
Kotaro Yamashita1, Makoto Yamasaki2, Yasuhiro Miyazaki3
1Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2-E2 Yamada-oka, Suita City, Osaka, 565-0871, Japan. kyamashita@gesurg.med.osaka-u.ac.jp.
Purpose:
To evaluate if nutritional supplements can attenuate postoperative catabolism in esophageal cancer patients after radical esophagectomy.
Methods:
We analyzed data prospectively from 30 patients who underwent curative esophagectomy for esophageal cancer between August and December, 2019. We compared postoperative nitrogen balance and changes in body composition between patients who received protein-enhanced enteral feeds (PEF) or other enteral feeds (OF).
Results:
Postoperative enteral feeding was administered safely to all patients. The average nitrogen balance was significantly higher in the PEF group than in the OF group on postoperative days (PODs) 3 (2.41 vs. - 1.50 g, P = 0.002), 4 (3.74 vs. - 0.08 g, P = 0.006), and 5 (3.27 vs. 0.11 g, P = 0.031). The cumulative nitrogen balance in the 7 days after surgery was significantly higher in the PEF group than in the OF group (6.12 vs. - 8.40 g, P = 0.025). The bodyweight loss and lean body mass loss on POD 14 were equivalent in the two groups (bodyweight loss 3.70 vs. 2.87%, P = 0.25; lean body mass loss, 4.34 vs. 1.91%, P = 0.33).
Conclusions:
PEF improved the postoperative nitrogen balance significantly in patients who underwent esophagectomy.
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