P1.092. Nutritional Outcomes Following Omission of Routine Feeding Jejunostomy (FJ) After Oesophagectomy: The Role of Specialist Dietetic Support

Abstract

Esophageal Cancer: Surgical Treatment of Esophageal Cancer – early outcomes and complications Patients recovering from oesophagectomy are at high risk of malnutrition due to altered gastrointestinal anatomy, the need to change dietary habits, and postoperative symptoms including dysphagia and dumping syndrome. FJ placement has traditionally supported postoperative nutrition; however, minimally invasive and robotic surgical techniques have reduced routine FJ use. Specialist oesophago-gastric dietetic input is therefore essential to support recovery, optimise oral intake, and identify patients requiring additional nutritional support. This study evaluates the impact of discontinuing routine FJ placement, focusing on oral nutritional supplement use, delayed requirement for enteral nutrition support, and postoperative weight change following surgery. A retrospective analysis was conducted of consecutive patients undergoing oesophagectomy at a single centre between October 2023 & June 2025. Patients were grouped according to FJ placement (FJ vs no-FJ). All patients received ongoing support from a specialist oesophago-gastric dietitian throughout recovery. Outcomes included ONS utilisation and tolerance, delayed requirement for ENS following discharge, and median weight change at 3–4 and 12 months postoperatively. A total of 112 patients were included (54 FJ vs 58 no-FJ). Patients managed without routine FJ demonstrated greater reliance on ONS, with 38% advised to trial ONS compared to 17% in the FJ group. Tolerance was variable, with 20% experiencing poor tolerance, leading to reduced adherence. In the no-FJ group, 19% required delayed ENS, whereas no patients in the FJ group required new enteral access. Median weight loss at 3–4 months was greater in the no-FJ group (−10.1 kg vs −4.5 kg), and this difference persisted at 12 months (−9.25 kg vs −6.0 kg). Omission of routine FJ placement following oesophagectomy increases reliance on ONS, although tolerance may be limited, and a subset of patients require delayed ENS. The significant nutritional challenges in this population underscore the importance of specialist dietetic support to guide recovery and escalate care where needed. Greater weight loss observed in patients without FJ highlights the need for careful patient selection and close multidisciplinary follow-up. A selective approach to FJ placement may reduce unnecessary intervention while ensuring adequate nutritional support in higher-risk patients.