Chewing 50 times per bite could help to resume oral feeding on the first postoperative day following minimally invasive oesophagectomy.

OBJECTIVES: In our previous study, early oral feeding following McKeown minimally invasive oesophagectomy (MIE) has been shown to be a safe and a feasible approach for early recovery of intestinal function and an improvement of quality of life. This study investigates the effect of 'chewing 50 times per bite' on early oral feeding following MIE.

METHODS: Between May 2016 and December 2016, we retrospectively analysed 95 cases of oesophageal carcinoma in patients who underwent MIE in our department. All patients received instructions for a 'chewing 50 times per bite' method for solid food intake on postoperative day (POD) 1. The primary end-points were the incidence of pneumonia and anastomotic leakage rate. In addition, postoperative nutritional status was studied.

RESULTS: Overall, 95 patients willingly started oral nutrition on POD 1. The rates of anastomotic leakage and pneumonia incidence were 2.1% and 7.4%, respectively. The caloric intake means on POD 1, POD 3 and POD 5 were 1388 ± 184, 1549 ± 206 and 1522 ± 203 respectively, which were 78%, 88% and 77% of the mean caloric requirements, respectively. There were no significant differences in protein index values between the preoperative measurements and the hospital discharge measurements.

CONCLUSIONS: The '50 chewing times per bite' solid food intake method on POD 1 in patients with MIE was shown to be feasible and safe, because the application of this method helps to convert solid food into liquid nutrition. More importantly, we demonstrated that it is possible for patients to be able to eat at will on Day 1 following MIE.