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Transcervical Gastric Tube Drainage Facilitates Patient Mobility and Reduces the Risk of Pulmonary Complications After Esophagectomy

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Journal of Gastrointestinal Surgery

Abstract

Background

Standard nasogastric decompression following esophagectomy is associated with reduced patient comfort and mobility and impaired hypopharyngeal function—predisposing the patient to sinusitis, pharyngitis, and the risk of aspiration. In this study, we evaluate the results of the transcervical gastric tube drainage in the setting of esophagectomy.

Methods

Transcervical gastric tube decompression was performed on 145 consecutive patients undergoing open esophagectomy between 2003 and 2007. Postoperative outcome variables include morbidity, mortality, esophagostomy duration, and length of stay.

Results

There were 107 males and 38 females (median age = 66; range = 37–87). Perioperative mortality was 2.8%. Major complications included five anastomotic leaks (3.4%), ten pneumonias (6.9%), two myocardial infarctions (1.4%), and the need for reoperation in four patients (bleeding, dehiscence). Median duration of transcervical drainage was 8 days. No tubes were dislodged prematurely. There were no bleeding complications. Four patients developed cellulitis near the cervical gastric tube site and were treated successfully with antibiotics and/or tube removal.

Conclusions

Transcervical gastric decompression can be performed safely with minimal complication risk. Inadvertent tube removal was not encountered in this series. The use of this technique may help to promote accelerated patient mobilization, greater patient comfort, and a durable means of gastric decompression.

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Acknowledgements

The authors wish to acknowledge the important contributions of Kathy Lovas, Theresa Krupka, Diane Sabilla, and Darla Justus in database organization and management.

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Authors and Affiliations

  1. Division of Thoracic and Foregut Surgery; Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Shadyside Medical Building—Suite 715, 5200 Centre Avenue, Pittsburgh, PA, 15232, USA

    Matthew J. Schuchert, Brian L. Pettiford, Joshua P. Landreneau, Jonathon Waxman, Arman Kilic, Ricardo S. Santos, Michael S. Kent, Amgad El-Sherif, Ghulam Abbas & Rodney J. Landreneau

  2. Division of Thoracic and Foregut Surgery; Heart, Lung and Esophageal Surgery Institute, UPMC Health System, Presbyterian University Hospital, Suite C-800, 200 Lothrop St., Pittsburgh, PA, 13213, USA

    James D. Luketich

Authors
  1. Matthew J. Schuchert
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  2. Brian L. Pettiford
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  3. Joshua P. Landreneau
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  4. Jonathon Waxman
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  5. Arman Kilic
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  6. Ricardo S. Santos
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  7. Michael S. Kent
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  8. Amgad El-Sherif
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  9. Ghulam Abbas
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  10. James D. Luketich
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  11. Rodney J. Landreneau
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Corresponding author

Correspondence to Matthew J. Schuchert.

Additional information

Meeting Presentation: The Society for Surgery of the Alimentary Tract 48th Annual Meeting, Washington D.C., May 19–23, 2007.

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Schuchert, M.J., Pettiford, B.L., Landreneau, J.P. et al. Transcervical Gastric Tube Drainage Facilitates Patient Mobility and Reduces the Risk of Pulmonary Complications After Esophagectomy. J Gastrointest Surg 12, 1479–1484 (2008). https://doi.org/10.1007/s11605-008-0541-8

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  • DOI: https://doi.org/10.1007/s11605-008-0541-8

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