Introduction: Nasogastric (NG) tube is regularly placed across cervical esophagogastric anastomosis (CEGA) after esophagectomy. The various enhanced recovery after surgery (ERAS) protocols have suggested either early removal or not placing of NG tube. However, it is still being used due to the fear of anastomotic leak. We studied the impact of exclusion of the NG tube after CEGA and compared it with its early removal.

Methods: The study was conducted prospectively from July 2018 until June 2022, where esophagectomy patients for esophageal cancer were divided into groups: with NG tubes (Group 1) and without NG tubes (Group 2) after CEGA. The standard ERAS protocol was followed. In the NG tube group, it was removed on a post-operative day (POD) 3. The primary outcome was the incidence of anastomotic leak, and the other variables compared were post-operative hospital stay and Clavien-Dindo > IIIa complications.

Results: Out of 45 patients, 29 in group 1 were compared with 16 in group 2. The median age of the patients was comparable (p = 0.3), with predominant histology as squamous cell carcinoma (97%). The total incidence of anastomosis leak was 15% which was comparable in both groups (5 vs. 2 p = 1.0). The median postoperative hospital stay (p=0.09) and Clavien-Dindo complications >IIIa (p=0.73) were comparable between the two groups. There was no perioperative mortality in both groups.

Conclusion: The omission of an NG tube after performing CEGA post-esophagectomy did not impact the anastomotic leak rate and had comparable other complications.