比较食管切除术后早期经口喂养和采用空肠造口喂养支持的晚期经口喂养的营养和术后结果。食管切除术与体重大幅减轻和营养不良有关，影响食管癌患者的预后。尽管有许多关于食管切除术后营养支持的研究，但最佳策略仍然难以捉摸。本研究探讨了空肠造口喂养与晚期经口喂养相比传统经口喂养对营养和术后结局的影响。我们在 2020 年至 2022 年间进行了一项单中心前瞻性开放标签随机对照试验。对象为年龄 18 至 75 岁的可切除食管患者癌症患者在食管切除术后被随机分配接受早期经口喂养（早期组）或晚期经口喂养并采用空肠造口喂养支持（晚期组）。主要终点是术后 4-5 周和 4 个月时体重较术前减轻。还评估了其他围手术期和营养结果。我们将 29 名患者随机分配到早期组，将 29 名患者分配到晚期组。晚期组在术后4-5周（8.3% vs. 5.6%；P=0.002）和4个月（15.0% vs. 10.5%；P=0.003）时体重减轻均显着减少。晚期组术后 4-5 周（1800 kcal/天 vs. 1100 kcal/天；P<0.001）和 4 个月（1565 kcal/天 vs. 1200 kcal/天）的总热量摄入和蛋白质摄入量较高P=0.010）。早期组有60%发生营养不良状态，晚期组有40%发生营养不良。并发症发生率和住院时间相似。晚期组证明可以预防显着体重减轻、增强营养摄入并减少营养不良，且不会影响短期手术结果。版权所有 © 2024 Wolters Kluwer Health, Inc. 保留所有权利。

To compare nutritional and postoperative outcomes between early oral feeding and late oral feeding with jejunostomy feeding support after esophagectomy.Esophagectomy is associated with substantial body weight loss and malnutrition, impacting the prognosis of esophageal cancer patients. Despite many studies on post-esophagectomy nutritional support, optimal strategies remain elusive. This study investigates the impact of jejunostomy feeding with late oral feeding compared to conventional oral feeding on nutritional and postoperative outcomes.We performed a single-center prospective open-labelled randomized controlled trial between 2020 and 2022. Patients aged 18 to 75 years with resectable esophageal cancer were randomly assigned to undergo either early oral feeding (early group) or late oral feeding with jejunostomy feeding support (late group) after esophagectomy. The primary endpoint was body weight loss from preoperative body weight at postoperative 4-5 weeks and 4 months. Other perioperative and nutritional outcomes were also evaluated.We randomly assigned 29 patients to the early group and 29 patients to the late group. The late group exhibited significantly less body weight loss at both postoperative 4-5 weeks (8.3% vs. 5.6%; P=0.002) and 4 months (15.0% vs. 10.5%; P=0.003). The total calorie intake and protein intake were higher in the late group for both postoperative 4-5 weeks (1800 kcal/day vs. 1100 kcal/day; P<0.001) and 4 months (1565 kcal/day vs. 1200 kcal/day; P=0.010). Sixty percentage of early group changed to malnutrition state, while 40% of the late group changed to malnutrition. The complication rate and length of hospital stays were similar.The late group demonstrated prevention of significant body weight loss, enhanced nutritional intake, and reduces malnutrition without compromising short-term surgical outcomes.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.