Quan Wu1, Jian-Chun Yu, Wei-Ming Kang, Zhi-Qiang Ma. 1. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Abstract
BACKGROUND: Most gastric cancer patients who undergo gastrectomy develop malnutrition. It is, therefore, crucial to establish an effective means to provide nutrition for these patients. To perform home enteral nutrition (EN) to ensure adequate nutritional intake in gastric cancer patients, we placed a jejunostomy catheter during gastric surgery. Most patients showed improved nutritional status. METHODS: Twenty-nine inpatients at our hospital underwent radical gastrectomy and jejunostomy from December 2002 to December 2007 and were designated as the jejunostomy group, and 32 matched patients without a jejunostomy tube were designated as the tube-free group. The jejunostomy group was treated with EN from 72 hours to 3 months postoperatively. The tube-free group did not receive EN. Data including preoperative and postoperative body weight, body mass index (BMI), nutrition risk screening (NRS) score, Karnofsky performance score (KPS), and laboratory biochemical indicators were documented respectively and compared. RESULTS: Compared with preoperative week 1, both groups showed decreased body weight and BMI at 3 months postoperatively. The weight loss in the jejunostomy group ((7.1 ± 3.3) kg) was significantly less than that in the tube-free group ((9.9 ± 3.1) kg). Similarly, BMI decreased by (2.4 ± 1.0) kg/m(2) in the jejunostomy group, which was significantly less than in the tube-free group ((3.2 ± 0.9) kg/m(2)). The number of patients with postoperative NRS ≥ 3 was decreased in the jejunostomy group, but was increased in the tube-free group, and this difference was significant. There were no significant differences between the two groups in total lymphocyte count, hemoglobin, albumin and prealbumin, and adverse drug effects. CONCLUSIONS: Short-term (3 months) EN supplementation via jejunostomy tube can reduce the risk of malnutrition and weight loss, and improve tolerance of chemotherapy. Tube feeding is reliable for achieving these goals because it is not important whether or not the patients have appetites.
BACKGROUND: Most gastric cancerpatients who undergo gastrectomy develop malnutrition. It is, therefore, crucial to establish an effective means to provide nutrition for these patients. To perform home enteral nutrition (EN) to ensure adequate nutritional intake in gastric cancerpatients, we placed a jejunostomy catheter during gastric surgery. Most patients showed improved nutritional status. METHODS: Twenty-nine inpatients at our hospital underwent radical gastrectomy and jejunostomy from December 2002 to December 2007 and were designated as the jejunostomy group, and 32 matched patients without a jejunostomy tube were designated as the tube-free group. The jejunostomy group was treated with EN from 72 hours to 3 months postoperatively. The tube-free group did not receive EN. Data including preoperative and postoperative body weight, body mass index (BMI), nutrition risk screening (NRS) score, Karnofsky performance score (KPS), and laboratory biochemical indicators were documented respectively and compared. RESULTS: Compared with preoperative week 1, both groups showed decreased body weight and BMI at 3 months postoperatively. The weight loss in the jejunostomy group ((7.1 ± 3.3) kg) was significantly less than that in the tube-free group ((9.9 ± 3.1) kg). Similarly, BMI decreased by (2.4 ± 1.0) kg/m(2) in the jejunostomy group, which was significantly less than in the tube-free group ((3.2 ± 0.9) kg/m(2)). The number of patients with postoperative NRS ≥ 3 was decreased in the jejunostomy group, but was increased in the tube-free group, and this difference was significant. There were no significant differences between the two groups in total lymphocyte count, hemoglobin, albumin and prealbumin, and adverse drug effects. CONCLUSIONS: Short-term (3 months) EN supplementation via jejunostomy tube can reduce the risk of malnutrition and weight loss, and improve tolerance of chemotherapy. Tube feeding is reliable for achieving these goals because it is not important whether or not the patients have appetites.
Authors: Juul J W Tegels; Michiel F G De Maat; Karel W E Hulsewé; Anton G M Hoofwijk; Jan H M B Stoot Journal: World J Gastroenterol Date: 2014-10-14 Impact factor: 5.742