Conventional Oral Intake vs Delayed Oral Intake With Jejunostomy Feeding After Esophagectomy (JNS Study)

NCT ID: NCT05318404

Last Updated: 2022-11-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

58 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-08

Study Completion Date

2022-11-08

Brief Summary

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Comparison of nutritional and early surgical outcome between early and delayed oral feeding after esophagectomy for esophageal cancer

Detailed Description

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Esophageal cancer is a highly aggressive malignancy that metastasizes to the lymph nodes and is associated with a poor prognosis. The 5-year overall survival rate is 40.0 % and the 30-day mortality rate is 1.7 %. Surgical resection is the most effective treatment for localized esophageal cancer; however, esophagectomy is extremely invasive and is associated with high morbidity and mortality rates.

Nutrition is one of the most important factors to consider after esophagectomy in order to reduce surgical mortality. The European Society for Parenteral and Enteral Nutrition guidelines recommend early tube feeding after major gastrointestinal surgery for cancer. Several studies have shown that enteral nutrition is more effective than parenteral nutrition in reducing postoperative complications in postesophagectomy patients. It has been reported that 5 to 7 days are required for anastomosis site healing. Therefore, many centers start oral feeding after esophagectomy on postoperative 7 days after anastomosis site evaluation, and enteral feeding via jejunostomy are maintained for nutritional support. However, the optimal timing for oral feeding after esophagectomy is still under debate.

In our center, the investigators routinely place jejunostomy tube for sufficient enteral feeding after esophagectomy. Before 2014, the investigators started oral feeding 5 to 7 days after esophagectomy and patients were discharged with soft blended diet. After 2014, the investigators changed our postoperative management protocols: 1) the investigators started only liquid diet 5 to 7 days after esophagectomy and maintained this feeding regimen until the first postoperative clinic visit with supplement of enteral feeding by jejunostomy tube. However, no studies have been conducted showing the optimal timing for oral feeding for esophagectomy patients for nutritional support and postoperative care.

The investigators hypothesized that delayed oral feeding after esophagectomy with jejunostomy feeding is superior to conventional oral feeding for nutritional support and early clinical outcome.

Conditions

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Esophageal Cancer Surgery Jejunostomy; Complications Nutrition Related Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Conventinal feeding group

Start oral feeding 5-7 days after esophagectomy and discharge with soft blended diet as major energy source

Group Type NO_INTERVENTION

No interventions assigned to this group

Delayed feeding group

Start clear liquid fluid diet 5-7 days after esophagectomy and discharge with jejunostomy feeding as the major energy source. Start oral feeding at postoperative 1st visit

Group Type EXPERIMENTAL

Jejunostomy feeding

Intervention Type DIETARY_SUPPLEMENT

Maintain jejunostomy feeding till postoperative 1st visit after esophagectomy in delayed feeding group

Interventions

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Jejunostomy feeding

Maintain jejunostomy feeding till postoperative 1st visit after esophagectomy in delayed feeding group

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Patients who planned to undergo esophagectomy with esophageal reconstruction for esophageal cancer for curative purpose
* Patients who can understand the purpose and protocol of the clinical trial

Exclusion Criteria

* BMI \< 18kg/m2 or BMI \> 25kg/m2
* Patients who needs colon of jejunum for esophageal reconstruction
* Patients who needed enteral feeding before esophagectomy
* Preoperative major organ failure (ex. renal failure requiring renal replacement, hepatic failure)
* Severe metabolic disorder (ex. uncontrolled diabetes mellitus, uncontrolled thyroid disease)
* Other patients who are not suitable for clinical trial
Minimum Eligible Age

19 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Seoul National University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Seoul National University Hospital

Seoul, , South Korea

Site Status

Countries

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South Korea

Other Identifiers

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2020-1756

Identifier Type: -

Identifier Source: org_study_id

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