Daisuke Kobayashi1, Kiyoshi Ishigure2, Yoshinari Mochizuki3, Hiroshi Nakayama4, Mitsuru Sakai5, Seiji Ito6, Hiroshi Kojima7, Masaki Kajikawa8, Masahiko Ando9, Yasuhiro Kodera10. 1. Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. kobadai@med.nagoya-u.ac.jp. 2. Department of Surgery, Konan Kosei Hospital, Konan, Japan. 3. Department of Surgery, Komaki City Hospital, Komaki, Japan. 4. Department of Surgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan. 5. Department of Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan. 6. Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan. 7. Gastroenterological Surgery, Aichi Cancer Center Aichi Hospital, Okazaki, Japan. 8. Department of Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Japan. 9. Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan. 10. Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Abstract
BACKGROUND: Postoperative malnutrition after gastrectomy is deemed inevitable, which could have prejudicial influence on survival for gastric cancer patients. A prospective feasibility study was conducted to evaluate the efficacy of postoperative oral nutritional supplements. METHODS: Stage I-III gastric cancer patients who underwent distal or total gastrectomy received oral administration of Racol® NF (Otsuka Pharmaceutical Factory, Japan), a liquid enteral nutritional formula, as a supplement to regular meals. Racol® NF administration at a recommended dosage of 400 kcal/400 ml per day was started within 7 days postoperatively and was continued for 3 months postoperatively. The primary end point was ratio of the weight loss at 3 months postoperatively to the preoperative body weight (body weight loss ratio). Secondary end points were the adherence to Racol® NF therapy and changes in body composition. RESULTS: One hundred eighteen patients were registered before surgery, 82 of whom were eligible for efficacy analyses. The average rate of body weight loss after 3 months postoperatively was 8.3%. The mean daily intake of Racol® NF was 211 ml. There was a significant correlation between adherence to Racol® NF therapy and body weight loss ratio (P < 0.001). Adherence to Racol® NF therapy was the only factor that correlated with the body weight loss ratio among all clinical characteristics by the multiple linear regression analysis (P = 0.007). CONCLUSIONS: Oral nutritional supplementation with Racol® NF led to a significant reduction in body weight loss for gastrectomized patients who tolerated more than 200 ml of the nutrient per day compared with those who could not tolerate this amount.
BACKGROUND:Postoperative malnutrition after gastrectomy is deemed inevitable, which could have prejudicial influence on survival for gastric cancerpatients. A prospective feasibility study was conducted to evaluate the efficacy of postoperative oral nutritional supplements. METHODS: Stage I-III gastric cancerpatients who underwent distal or total gastrectomy received oral administration of Racol® NF (Otsuka Pharmaceutical Factory, Japan), a liquid enteral nutritional formula, as a supplement to regular meals. Racol® NF administration at a recommended dosage of 400 kcal/400 ml per day was started within 7 days postoperatively and was continued for 3 months postoperatively. The primary end point was ratio of the weight loss at 3 months postoperatively to the preoperative body weight (body weight loss ratio). Secondary end points were the adherence to Racol® NF therapy and changes in body composition. RESULTS: One hundred eighteen patients were registered before surgery, 82 of whom were eligible for efficacy analyses. The average rate of body weight loss after 3 months postoperatively was 8.3%. The mean daily intake of Racol® NF was 211 ml. There was a significant correlation between adherence to Racol® NF therapy and body weight loss ratio (P < 0.001). Adherence to Racol® NF therapy was the only factor that correlated with the body weight loss ratio among all clinical characteristics by the multiple linear regression analysis (P = 0.007). CONCLUSIONS: Oral nutritional supplementation with Racol® NF led to a significant reduction in body weight loss for gastrectomized patients who tolerated more than 200 ml of the nutrient per day compared with those who could not tolerate this amount.
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