Home enteral nutrition after minimally invasive esophagectomy can improve quality of life and reduce the risk of malnutrition

Background and Objectives: The potential benefits of home enteral nutrition (HEN) and the effects of HEN on quality of life (QOL) after esophagectomy remain unclear. The aim was to investigate the effect of 3 months HEN on health related QOL and nutritional status of esophageal cancer patients who were preoperatively malnourished. Methods and Study Design: 142 malnourished (PG-SGA stage B or C) patients with esophageal cancer were assigned to receive Ivor Lewis minimally invasive esophagectomy (MIE group) with laparoscopic je-junal feeding tube placement or open esophagectomy (OE group) with nasojejunal feeding tube placement. After discharge, patients in the MIE group received HEN with 500-1000 kcal/d for 3 months, while the OE group patients did not receive HEN, as nasojejunal feeding tubes had been removed. QLQ-C30 and PG-SGA questionnaires were used to evaluate the QOL and the risk of malnutrition. Results: 67 patients were enrolled in the MIE group and 75 patients were enrolled in the OE group. Symptoms related to fatigue, nausea, vomiting, pain, and appetite loss were significantly decreased in the patients treated with 3 months HEN. Similarly, patients treated with 3 months HEN had a lower risk of malnutrition than patients did not receive HEN (PG-SGA score, 5.7 vs 7.9, p<0.01). More patients in the MIE group (received 3 months HEN) were able to complete postoperative chemoradiotherapy than patients in the OE group (p<0.01). Conclusions: MIE and subsequent treatment with 3 months HEN can improve the QOL and reduce the risk of malnutrition in preoperatively malnourished patients.