Evidence map›Paper›PMID 40971833›Full record

Observational studyDiseases of the esophagus : official journal of the International Society for Diseases of the Esophagus2025

Early versus late oral feeding regimens following esophagectomy: a propensity score-matched observational cohort.

Cezanne D Kooij, Lucas Goense, B Feike Kingma, Robin B den Boer, Elles Steenhagen, Jelle P Ruurda, Richard van Hillegersberg

Abstract readObservational StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Trajectories of postoperative nutritional risk changes in patients with oesophageal cancer and their relationship with symptom recovery-a multicentre longitudinal study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Cezanne D KooijDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID 0000-0001-5985-0075
Lucas GoenseDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
B Feike KingmaDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Robin B den BoerDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Elles SteenhagenDepartment of Dietetics, University Medical Center Utrecht, Utrecht, The Netherlands.
Jelle P RuurdaDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Richard van HillegersbergDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.ORCID 0000-0002-7134-261X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe optimal time to resume oral intake after esophagectomy remains debated, with practices varying across centers.

methodsThis single-center, retrospective cohort study compared early and late oral feeding regimens after esophagectomy. Perioperative care was identical except for the feeding regimen. Early oral feeding began immediately post-surgery, while late oral feeding started on postoperative day 4 after swallow examination, with jejunostomy for early enteral tube feeding. Propensity score matching was used to reduce confounding. The primary outcome was overall survival. Secondary outcomes included complications, need for an alternative feeding route, hospital stay, readmission, and 90-day mortality.

resultsBetween May 2017 and October 2023, 406 patients underwent an esophagectomy (312 transthoracic; 94 transhiatal). After matching, 139 patients were included in both the early and late oral feeding groups. Overall complication rates did not significantly differ (84.9% vs. 77.7%; P = 0.124), but the late oral feeding group had less severe complications (48.9% vs. 36.7%; P = 0.039). The late oral feeding group showed lower leakage rates in intrathoracic anastomosis (33.3% vs. 13.3%; P = 0.008), but no differences for cervical anastomosis. The late oral feeding group had a shorter median hospital stay (12 vs. 11 days, P = 0.008). No differences in overall survival rates were found (Kaplan-Meier: P = 0.604, Cox regression: HR: 1.020, 95% CI 0.729-1.427, P = 0.907).

conclusionsEarly and late oral feeding showed similar survival rates, but late oral feeding was associated with fewer severe complications, lower anastomotic leakage, and shorter hospital stay. Therefore, despite no survival difference, late oral feeding with jejunal feeding may lead to better postoperative outcomes.

Indexed as

Enteral NutritionEsophageal NeoplasmsEsophagectomyPostoperative CareAgedFemaleHumansJejunostomyLength of StayMaleMiddle AgedPostoperative ComplicationsPropensity ScoreRetrospective StudiesTime FactorsTreatment Outcomeesophagectomynutritionsurvival

Identifiers

PMID40971833
PMCPMC12490072

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.