Enteral nutrition during postoperative hospitalization improves your tolerance to treatment, increases the safety of surgery, reduces the rate of postoperative complications, and also accelerates recovery. However, as the length of stay after esophageal cancer surgery has gradually decreased, post-discharge nutritional management has become a major part of recovery.
After discharge, you will also need adjunctive enteral nutrition therapy
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In reality, you have not fully transitioned to oral feeding at the time of discharge. Even if you are able to eat by mouth, you are not eating enough to meet your body’s needs and your protein and micronutrient intake is far from the recommended amount due to the change in eating habits and decreased appetite after GI reconstruction.
Therefore, adjuvant enteral nutrition support therapy is still needed to ensure your nutritional level. The post-discharge enteral nutrition approach is mostly by syringe push or gravity drip, and because the speed is difficult to control, you quickly develop dumping-like syndrome with abdominal pain, bloating, and diarrhea after a short, large amount of nutrient solution enters the jejunum. Some patients are unable to tolerate this, leading to increased associated intestinal complications and inadequate nutritional intake.
How to do home enteral nutrition?
Studies have found that continuous pumping of enteral nutrition after discharge improves patient safety, facilitates weight maintenance after discharge, increases enteral nutrition tolerance, ensures effective completion of nutrition support, and also reduces length of stay and costs. Therefore, at discharge you also need to keep the nasojejunal nutrition tube, purchase an enteral nutrition pump, and continue enteral nutrition support therapy.
Your daily energy intake is generally 25-30 kcal per kg body weight, and your energy source is exclusively enteral nutrition preparations for 2 weeks after discharge from the hospital. 2 weeks later, under the direction of your thoracic surgeon and dietitian, you will begin to eat by mouth and gradually reduce enteral nutrition supplementation until 25-35 days postoperatively. Thereafter, you can gradually return to your daily diet.