Top

Published in:

01-02-2017 | Original Article

Early Enteral Nutrition Versus Parenteral Nutrition After Resection of Esophageal Cancer: a Retrospective Analysis

Authors: Huan Ming Yu, Cheng Wu Tang, Wen Ming Feng, Qiu Qiang Chen, Yong Qiang Xu, Ying Bao

Published in: Indian Journal of Surgery | Issue 1/2017

Abstract

This study aimed to compare the clinical outcomes and hospitalization cost between early enteral nutrition (EEN) and parenteral nutrition (PN) after resection of esophageal cancer. A total of 79 patients with esophageal cancer who underwent surgical treatment in our hospital from July 2010 to July 2013 were enrolled in this study. They were divided into EEN group (n = 39) and PN group (n = 40) based on the nutrition support modes. The clinical factors such as time to first fecal passage, postoperative albumin infusion, differences of serum albumin value, hospital stay, systematic inflammatory response syndrome (SIRS) duration, complications, initial hospitalization cost, and mortality were retrospectively compared. The EEN group had a significantly shorter hospital stay, lower initial hospitalization cost, earlier first fecal passage, and shorter duration of SIRS than PN group (P < 0.05). The dose of albumin infusion was significantly smaller in EEN group (P < 0.05) and the decreased value of serum albumin (Δalb) was more prominent in PN group compared with EEN group (P < 0.05). The percentage of patients having any postoperative complication was much higher in PN group than EEN group (P < 0.05), but there was no significant difference in in-hospital morbidity between two groups. Pneumonia was found significantly more frequent in PN group compared with EEN group (P < 0.05). Early EN started within 48 h after esophagectomy is safe, economic, and superior for reduction of postoperative complication, for promoting early recovery of intestinal movement, and for early recovery from systemic inflammation.

Wang JB, Fan JH, Liang H, Li J, Xiao HJ, Wei WQ, Dawsey SM, Qiao YL, Boffetta P (2012) Attributable causes of esophageal cancer incidence and mortality in China. PLoS One 7(8):e42281. doi:10.1371/journal.pone.0042281 CrossRefPubMedPubMedCentral

Biere SS, van Berge Henegouwen MI, Maas KW, Bonavina L, Rosman C, Garcia JR, Gisbertz SS, Klinkenbijl JH, Hollmann MW, de Lange ES, Bonjer HJ, van der Peet DL, Cuesta MA (2012) Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 379(9829):1887–1892. doi:10.1016/S0140-6736(12)60516-9 CrossRefPubMed

Bailey SH, Bull DA, Harpole DH, Rentz JJ, Neumayer LA, Pappas TN, Daley J, Henderson WG, Krasnicka B, Khuri SF (2003) Outcomes after esophagectomy: a ten-year prospective cohort. Ann Thorac Surg 75(1):217–222, discussion 222CrossRefPubMed

Enzinger PC, Mayer RJ (2003) Esophageal cancer. N Engl J Med 349(23):2241–2252. doi:10.1056/NEJMra035010 CrossRefPubMed

Jiang K, Cheng L, Wang JJ, Li JS, Nie J (2009) Fast track clinical pathway implications in esophagogastrectomy. World J Gastroenterol 15(4):496–501CrossRefPubMedPubMedCentral

Cao S, Zhao G, Cui J, Dong Q, Qi S, Xin Y, Shen B, Guo Q (2013) Fast-track rehabilitation program and conventional care after esophagectomy: a retrospective controlled cohort study. Support Care Cancer 21(3):707–714. doi:10.1007/s00520-012-1570-0 CrossRefPubMed

Fujita T, Daiko H, Nishimura M (2012) Early enteral nutrition reduces the rate of life-threatening complications after thoracic esophagectomy in patients with esophageal cancer. European surgical research Europaische chirurgische Forschung Recherches chirurgicales europeennes 48(2):79–84. doi:10.1159/000336574 CrossRefPubMed

Page RD, Oo AY, Russell GN, Pennefather SH (2002) Intravenous hydration versus naso-jejunal enteral feeding after esophagectomy: a randomised study. Eur J Cardiothorac Surg 22(5):666–672CrossRefPubMed

Watters JM, Kirkpatrick SM, Norris SB, Shamji FM, Wells GA (1997) Immediate postoperative enteral feeding results in impaired respiratory mechanics and decreased mobility. Ann Surg 226(3):369–377, discussion 377-380CrossRefPubMedPubMedCentral

10.

Llop-Talaveron JM, Farran-Teixidor L, Badia-Tahull MB, Virgili-Casas M, Leiva-Badosa E, Galan-Guzman MC, Miro-Martin M, Aranda-Danso H (2014) Artificial nutritional support in cancer patients after esophagectomy: 11 years of experience. Nutr Cancer 66(6):1038–1046. doi:10.1080/01635581.2014.939292 CrossRefPubMed

11.

Sobin LH, Wittekind C (2002) TNM Classification of Malignant Tumours, 6th edn. John Wiley & Sons, Hoboken, New York

12.

Smith T, Elia M (2006) Artificial nutrition support in hospital: indications and complications. Clin Med 6(5):457–460. doi:10.7861/clinmedicine.6-5-457 CrossRef

13.

Kosugi S, Kanda T, Yajima K, Ishikawa T, Hatakeyama K (2011) Risk factors that influence early death due to cancer recurrence after extended radical esophagectomy with three-field lymph node dissection. Ann Surg Oncol 18(10):2961–2967. doi:10.1245/s10434-011-1712-5 CrossRefPubMed

14.

Gabor S, Renner H, Matzi V, Ratzenhofer B, Lindenmann J, Sankin O, Pinter H, Maier A, Smolle J, Smolle-Juttner FM (2005) Early enteral feeding compared with parenteral nutrition after oesophageal or oesophagogastric resection and reconstruction. Br J Nutr 93(4):509–513CrossRefPubMed

15.

Sweeney KJ, Kell MR, Ravi N, Reynolds JV (2005) Major upper gastrointestinal surgery is associated with an antigen-dependent proinflammatory T cell response. Br J Surg 92(8):989–995. doi:10.1002/bjs.4844 CrossRefPubMed

16.

Heyland DK, Cook DJ, Guyatt GH (1993) Enteral nutrition in the critically ill patient: a critical review of the evidence. Intensive Care Med 19(8):435–442CrossRefPubMed

17.

Mochizuki H, Trocki O, Dominioni L, Brackett KA, Joffe SN, Alexander JW (1984) Mechanism of prevention of postburn hypermetabolism and catabolism by early enteral feeding. Ann Surg 200(3):297–310CrossRefPubMedPubMedCentral

18.

Fong YM, Marano MA, Barber A, He W, Moldawer LL, Bushman ED, Coyle SM, Shires GT, Lowry SF (1989) Total parenteral nutrition and bowel rest modify the metabolic response to endotoxin in humans. Ann Surg 210(4):449–456, discussion 456-447CrossRefPubMedPubMedCentral

19.

Saito H, Trocki O, Alexander JW, Kopcha R, Heyd T, Joffe SN (1987) The effect of route of nutrient administration on the nutritional state, catabolic hormone secretion, and gut mucosal integrity after burn injury. JPEN J Parenter Enteral Nutr 11(1):1–7CrossRefPubMed

20.

Lin MT, Saito H, Fukushima R, Inaba T, Fukatsu K, Inoue T, Furukawa S, Han I, Muto T (1996) Route of nutritional supply influences local, systemic, and remote organ responses to intraperitoneal bacterial challenge. Ann Surg 223(1):84–93CrossRefPubMedPubMedCentral

21.

Moore FA, Feliciano DV, Andrassy RJ, McArdle AH, Booth FV, Morgenstein-Wagner TB, Kellum JM Jr, Welling RE, Moore EE (1992) Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis. Ann Surg 216(2):172–183CrossRefPubMedPubMedCentral

22.

Mercer CD, Mungara A (1996) Enteral feeding in esophageal surgery. Nutrition 12(3):200–201CrossRefPubMed

23.

Aiko S, Yoshizumi Y, Sugiura Y, Matsuyama T, Naito Y, Matsuzaki J, Maehara T (2001) Beneficial effects of immediate enteral nutrition after esophageal cancer surgery. Surg Today 31(11):971–978CrossRefPubMed

24.

Ryan AM, Rowley SP, Healy LA, Flood PM, Ravi N, Reynolds JV (2006) Post-oesophagectomy early enteral nutrition via a needle catheter jejunostomy: 8-year experience at a specialist unit. Clin Nutr 25(3):386–393. doi:10.1016/j.clnu.2005.12.003 CrossRefPubMed

25.

Baigrie RJ, Devitt PG, Watkin DS (1996) Enteral versus parenteral nutrition after oesophagogastric surgery: a prospective randomized comparison. Aust N Z J Surg 66(10):668–670CrossRefPubMed

26.

Heslin MJ, Latkany L, Leung D, Brooks AD, Hochwald SN, Pisters PW, Shike M, Brennan MF (1997) A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy. Ann Surg 226(4):567–577, discussion 577-580CrossRefPubMedPubMedCentral

27.

Doig GS, Heighes PT, Simpson F, Sweetman EA, Davies AR (2009) Early enteral nutrition, provided within 24 h of injury or intensive care unit admission, significantly reduces mortality in critically ill patients: a meta-analysis of randomised controlled trials. Intensive Care Med 35(12):2018–2027. doi:10.1007/s00134-009-1664-4 CrossRefPubMed

28.

Manba N, Koyama Y, Kosugi S, Ishikawa T, Ichikawa H, Minagawa M, Kobayashi T, Wakai T (2014) Is early enteral nutrition initiated within 24 hours better for the postoperative course in esophageal cancer surgery? J Clin Med Res 6(1):53–58. doi:10.4021/jocmr1665w PubMed

Title: Early Enteral Nutrition Versus Parenteral Nutrition After Resection of Esophageal Cancer: a Retrospective Analysis
Authors: Huan Ming Yu
Cheng Wu Tang
Wen Ming Feng
Qiu Qiang Chen
Yong Qiang Xu
Ying Bao
Publication date: 01-02-2017
Publisher: Springer India
Published in: Indian Journal of Surgery / Issue 1/2017
Print ISSN: 0972-2068
Electronic ISSN: 0973-9793
DOI: https://doi.org/10.1007/s12262-015-1420-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Early Enteral Nutrition Versus Parenteral Nutrition After Resection of Esophageal Cancer: a Retrospective Analysis

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2017

Double Right Testicular Arteries Passing Through the Hiatus in the Trifurcated Testicular Vein

Hypospadiac Duplication of Anterior Urethra—a Rare Congenital Anomaly

Preputial Calculi: a Case Report and Review of Literature

A Broken Fruit Knife: Half in the Bronchus and Half in the Duodenum

Clinical Profile of Surgical Diseases with Emergence of New Problems in HIV+ Individuals

Laparoscopic Management of a Proximal Jejunal Gallstone Ileus with Patulous Ampulla and Choledochal Cyst—a Report of Unusual Presentation and a Review