The effect of thoracic epidural bupivacaine and an intravenous adrenaline infusion on gastric tube blood flow during esophagectomy.

Background: Gastric tube necrosis is a major cause of anastomotic leak after esophagectomy. A correlation has been shown between reduced flux at the anastomotic end of the gastric tube and anastomotic leaks.

Methods: We prospectively studied the effect of intraoperative thoracic epidural bupivacaine and subsequent adrenaline infusion on hemodynamics and flux in the gastric tube.

Intravenous hydration versus naso-jejunal enteral feeding after esophagectomy: a randomised study.

Objective: Patients undergoing esophagectomy are typically nutritionally depleted and cannot establish oral feeding for up to a week after surgery. We have investigated the routine use of enteral feeding via a naso-jejunal tube.

Methods: Forty consecutive patients undergoing a transthoracic esophagectomy for cancer were randomised to receive enteral feeding or intravenous crystalloid fluids after surgery.