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- Title
Effect of Early Full-Calorie Nutrition Support Following Esophagectomy: A Randomized Controlled Trial.
- Authors
Wei Wu; Ming Zhong; Du-ming Zhu; Jie-qiong Song; Jun-feng Huang; Qun Wang; Li-jie Tan; Wu, Wei; Zhong, Ming; Zhu, Du-Ming; Song, Jie-Qiong; Huang, Jun-Feng; Wang, Qun; Tan, Li-Jie
- Abstract
<bold>Background: </bold>Early use of enteral nutrition (EN) is indicated following surgical resection of esophageal cancer. However, early EN support does not always meet the optimal calorie or protein requirements, and the benefits of supplementary parenteral nutrition (PN) remain unclear. We aimed to evaluate the efficacy and safety of early supplementary PN following esophagectomy.<bold>Materials and Methods: </bold>We enrolled 80 consecutive patients who underwent esophagectomy. Resting energy expenditure and body composition measurements were performed in all patients preoperatively and postoperatively. EN was administered after surgery, followed by randomization to either EN+PN or EN alone. The amount of PN administered was calculated to meet the full calorie requirement, as measured by indirect calorimetry, and 1.5 g protein/kg fat-free mass (FFM) per day was added as determined by body composition measurement. The clinical characteristics were compared between the 2 groups.<bold>Results: </bold>Patients in the EN+PN group but not in the EN group preserved body weight (0.18 ± 3.38 kg vs -2.15 ± 3.19 kg, P < .05) and FFM (1.46 ± 2.97 kg vs -2.08 ± 4.16 kg) relative to preoperative measurements. Length of hospital stay, postoperative morbidity rates, and standard blood biochemistry profiles were similar. However, scores for physical functioning (71.5 ± 24.3 vs 60.4 ± 27.4, P < .05) and energy/fatigue (62.9 ± 19.5 vs 54.2 ± 23.5, P < .05) were higher in the EN+PN group 90 days following surgery.<bold>Conclusion: </bold>Early use of supplemental PN to meet full calorie requirements of patients who underwent esophagectomy led to better quality of life 3 months after surgery. Moreover, increased calorie and protein supplies were associated with preservation of body weight and FFM.
- Subjects
BODY composition; BODY fluids; BODY weight; COMPARATIVE studies; DIETARY supplements; DIGESTIVE organ surgery; ENERGY metabolism; ENTERAL feeding; ESOPHAGEAL tumors; FATIGUE (Physiology); LENGTH of stay in hospitals; INGESTION; RESEARCH methodology; MEDICAL cooperation; NUTRITIONAL requirements; PARENTERAL feeding; DIETARY proteins; QUALITY of life; RESEARCH; STATISTICAL sampling; SURGICAL complications; ACTIVITIES of daily living; EVALUATION research; RANDOMIZED controlled trials; PROTEIN-energy malnutrition; PREVENTION; THERAPEUTICS
- Publication
JPEN Journal of Parenteral & Enteral Nutrition, 2017, Vol 41, Issue 7, p1146
- ISSN
0148-6071
- Publication type
journal article
- DOI
10.1177/0148607116651509