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Table 3 Daily guideline of postoperative care of patients with FTS pathway vs conventional pathway

From: Fast-track surgery improves postoperative clinical recovery and cellular and humoral immunity after esophagectomy for esophageal cancer

Day FTS pathway Conventional pathway
POD1 Jejunostomy tube feeding 500 mL (starting at 20 mL/h)
Early postoperative mobilization program (>2 h out of bed)
Physical therapy and nebulizers
Remove urine catheter
Head of bed put at 30°
Supply albumin
Chest tube to suction
Promoted to lung recruitment
Total parenteral nutrition
Bed rest
Gastrointestinal decompression
Closed thoracic drainage
POD2 Jejunostomy tube feeding 1000 mL (40 mL/h)
Chest tube to suction
Expand mobilization (>4 h out of bed)
Continue physical therapy and nebulizers
Continue supply albumin
Nasojejunal tube feeding 500 mL (starting at 20 mL/h)
Remove urine catheter
With help, sit in the chair 2 times during the day for at least 30 min each time
Gastrointestinal decompression
Closed thoracic drainage
POD3 Jejunostomy tube feeding 1500 mL (60–80 mL/h)
Remove chest tube
Remove epidural catheter
Expand mobilization (>6 h out of bed)
Continue physical therapy and nebulizers
Continue supply albumin
Nasojejunal tube feeding 1000 mL (40 mL/h)
Sit in the chair 3 times for at least 30–60 min each time. With help, walk twice in the hallway.
Do deep breathing exercise
Remove nasogastric tube
Closed thoracic drainage
POD4 Gastrograffin opacification of upper gastrointestine
If swallow shows no leak, advance patient to oral drink
Jejunostomy tube feeding 1500 mL (60–80 mL/h)
Continue physical therapy and nebulizers
Education on aspiration precaution
Education on chewing and swallowing
Nasojejunal tube feeding 1000 mL (40 mL/h)
Sit in the chair 3 times today for at least 30–60 min each time. Walk the length of the hallway 3 times
Continue to do breathing exercises
Closed thoracic drainage
POD5 Jejunostomy tube feeding 1500 mL (60–80 mL/h)
Advance patient to a full liquid diet
Continue aspiration precautions
Continue physical therapy and nebulizers
Nasojejunal tube feeding 1500 mL (60–80 mL/h)
Walk the length of the hallway 4–5 times. Sit in the chair 3 times today for at least 30–60 min
Continue to do breathing exercises
POD6 Increase liquid diet
Decrease jejunostomy tube feeding (500 ml or 1000 ml)
Continue aspiration precautions
Continue physical therapy and nebulizers
Nasojejunal tube feeding 1500 mL (60–80 mL/h)
Remove chest tube
Walk the length of the hallway 4–5 times. Sit in the chair 3 times today for at least 30–60 min
Continue to do breathing exercises
POD7 Remove jejunostomy tube
Full liquid diet
Discharge home on soft diet and liquid diet
Continue aspiration precautions
Gastrograffin opacification of upper gastrointestine
If swallow shows no leak, advance patient to oral drink
Nasojejunal tube feeding 1500 mL (60–80 mL/h)
Expand mobilization (>4 h out of bed)
Continue to do breathing exercises
POD8   Increase liquid diet
Decrease jejunostomy tube feeding (500 ml or 1000 ml)
Expand mobilization (>6 h out of bed)
Continue to do breathing exercises
POD9   Remove nasojejunal tube
Full liquid diet
Expand mobilization (>6 h out of bed)
Continue to do breathing exercises
POD10-11   Soft diet and liquid diet
Nearly out of bed
Observe whether there is delayed anastomotic leakage
POD12   Discharge home on soft diet and liquid diet