Efficacy of double-point jejunostomy in laparoscopic surgery for esophageal cancer: a comparative study

Esophageal cancer is a malignant tumor prevalent worldwide, with its incidence rising annually, severely impacting patients' quality of life and survival. Surgical resection remains one of the primary treatment modalities for esophageal cancer. However, the postoperative recovery process is frequently complicated by malnutrition. This nutritional deficiency not only delays the patient's recovery but may also precipitate a series of complications, thereby further compromising the patient's prognosis. Consequently, timely and effective nutritional support post-surgery is crucial for the rehabilitation of esophageal cancer patients. This study aimed to evaluate the efficacy of modified laparoscopic jejunojejunostomy in esophageal cancer resection and to compare it with conventional nasojejunal tube placement, assessing its advantages in reducing postoperative complications and improving patient nutritional support.

We retrospectively analyzed data from 123 patients who underwent fully laparoscopic esophageal cancer resection in the Department of Thoracic Surgery at The First Affiliated Hospital of Soochow University between December 2022 and June 2025. Patients were divided into a study group (double-anastomotic stoma, n=45) and a control group (nasojejunal tube placement, n=78) based on postoperative nutritional support methods. Perioperative nutritional indicators, postoperative recovery, complication rates, and feeding tube-related adverse events were compared between the two groups.

There were no significant differences between the study group and the control group in terms of albumin levels, total protein levels, or changes in body mass index (BMI) before and after surgery (P>0.05). Only the albumin level measured three days after surgery was significant, with the two-point fistulization group performing better than the nutrition tube group. The postoperative hospital stay, fasting time, and tube retention time in the study group were significantly shorter than those in the control group (P<0.05). The feeding tube dropout rate in the study group was significantly lower than that in the control group (P<0.05). With regard to other complications, no significant differences were observed between the groups (P>0.05).

Laparoscopic double-point jejunostomy can effectively provide postoperative nutritional support, significantly reduce the risk of bowel obstruction and tube dislodgement, and improve the comfort of patient recovery after surgery. It is a safe and effective method of nutritional support, suitable for patients following total laparoscopic esophagectomy.