211 Effectiveness of a Semi-Elemental Feed on Gastrointestinal Tolerance and Chyle Leak Incidence After Oesophagectomy

Abstract Aim Despite improvements in surgical techniques and postoperative care, oesophagectomy continues to exhibit high mortality and morbidity rates. Currently, the commonly used approach to nutrition support is enteral feeding through a jejunostomy tube. While essential for recovery, it may also contribute or exacerbate complications including gastrointestinal intolerance and chyle leaks. This research aims to evaluate the impact of semi-elemental feeds against standard feeds on gastrointestinal tolerance, chyle leak incidence, chyle leak management and other postoperative outcomes after oesophagectomy. Method This study examined the medical records of patients who underwent oesophagectomy at a high-volume tertiary centre between November 2023 and October 2024, during which a semi-elemental feed was used. The data were subsequently compared to a previous cohort who underwent surgery between October 2022 and September 2023 where a standard feed was used. To assess the effect of semi-elemental feeds, the number of feed changes made resulted from intolerance, occurrence of chyle leaks, use of parenteral nutrition and length of stay were compared. Results 61 patients who received a semi-elemental feed postoperatively were compared to 78 patients who received a standard feed. The semi-elemental feed group demonstrated fewer chyle leaks (p=0.044) and improved gastrointestinal tolerance due to the lower number of feed changes made resulted from intolerance (p= 0.001). No differences were found regarding the use of parenteral nutrition (p=0.149) or length of stay (p=0.912). Conclusions This study established semi-elemental feeds as the superior option over standard feeds for optimal nutrition support for post-oesophagectomy patients due to improved gastrointestinal tolerance and reduced chyle leak incidence.