What is the primary feeding option recommended post-oesophagectomy?

Following an oesophagectomy, the primary feeding option recommended is feeding jejunostomy. This approach allows for direct access to the jejunum, bypassing the reconstructed esophagus or stomach to ensure adequate nutrition in the early postoperative period when normal swallowing and digestion may be compromised due to surgical changes.

Feeding jejunostomy provides several advantages. It supports early enteral nutrition, which is beneficial for maintaining gut function and reducing the risk of complications such as infections and gastrointestinal motility issues. Additionally, it allows for a more controlled and manageable way to deliver nutrients directly into the small intestine, which is particularly important since patients may experience anatomic and functional changes after surgery.

While orogastric tube feeding is less invasive and may be appropriate for short-term feeding, it can lead to discomfort, potential aspiration, and may not provide sufficient nutrition over time. Parenteral nutrition, although it bypasses the gastrointestinal tract entirely, should generally be reserved for patients who cannot tolerate enteral feeding due to complications or when there are difficulties in establishing enteral access. Gastrostomy feeding also offers an alternative but may not be as preferable as jejunostomy in this context, primarily due to the issues of reflux and potential for delayed gastric emptying post-s