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