Night Home Enteral Nutrition as a Novel Enforced and Effective Nutrition Therapy Following Esophagectomy for Esophageal Cancer Patients

Background Enteral nutrition has been reported to be effective in malnourished patients undergoing upper gastrointestinal surgery. In this study, we devised night home enteral nutrition (N-HEN) as a novel nutritional strategy without disturbing the daily activity and oral intake in esophageal cancer patients following curative esophagectomy. Methods Between January 2017 and March 2022, 27 patients were prospectively included in the protocol and supported by N-HEN for 3 postoperative months through a jejunostomy during every night (Elentala®:1200 kcal/600 mL/day), and 13 patients without N-HEN were followed as a control group (CG). Body weight loss, nutritional and sarcopenia indicators were evaluated. Results There was no difference of pathological factors between both groups, postoperative pneumonia was significantly lower in N-HEN. After 3, 6 and 12 months, patients with N-HEN had significantly less body weight loss than CG (3 months P < 0.001: N-HEN 2.3% vs. CG 6.9%, 6 months P < 0.001: N-HEN 3.0% vs. CG 11.6%, 12 months P < 0.001: N-HEN 6.0% vs. CG 11.9%). Psoas muscle mass index (cm2/m2) of iliopsoas muscle was significantly higher in N-HEN than CG after 6 and 12 months (6 months P < 0.05, 12 months P < 0.05), indicating the efficacy to avoid sarcopenia. Patients with N-HEN presented better long-term survivals than CG. Conclusion N-HEN could be a novel enforced and effective nutritional strategy without disturbing the daily activity and oral intake in patients following esophagectomy.