Zixiang Wu1, Ming Wu2, Qi Wang1, Tianwei Zhan1, Lian Wang1, Saibo Pan1, Gang Chen1. 1. Department of thoracic surgery, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China. 2. Department of thoracic surgery, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China. Email: iwuming22@zju.edu.cn.
Abstract
BACKGROUND AND OBJECTIVES: The potential benefits of home enteral nutrition (HEN) and the effects of HEN on quality of life (QOL) after esophagectomy remain unclear. The aim was to investigate the effect of 3 months HEN on health related QOL and nutritional status of esophageal cancer patients who were preoperatively malnourished. METHODS AND STUDY DESIGN:142 malnourished (PG-SGA stage B or C) patients with esophageal cancer were assigned to receive Ivor Lewis minimally invasive esophagectomy (MIE group) with laparoscopic jejunal feeding tube placement or open esophagectomy (OE group) with nasojejunal feeding tube placement. After discharge, patients in the MIE group received HEN with 500-1000 kcal/d for 3 months, while the OE group patients did not receive HEN, as nasojejunal feeding tubes had been removed. QLQ-C30 and PG-SGA questionnaires were used to evaluate the QOL and the risk of malnutrition. RESULTS:67 patients were enrolled in the MIE group and 75 patients were enrolled in the OE group. Symptoms related to fatigue, nausea, vomiting, pain, and appetite loss were significantly decreased in the patients treated with 3 months HEN. Similarly, patients treated with 3 months HEN had a lower risk of malnutrition than patients did not receive HEN (PG-SGA score, 5.7 vs 7.9, p<0.01). More patients in the MIE group (received 3 months HEN) were able to complete postoperative chemoradiotherapy than patients in the OE group (p<0.01). CONCLUSIONS: MIE and subsequent treatment with 3 months HEN can improve the QOL and reduce the risk of malnutrition in preoperatively malnourished patients.
RCT Entities:
BACKGROUND AND OBJECTIVES: The potential benefits of home enteral nutrition (HEN) and the effects of HEN on quality of life (QOL) after esophagectomy remain unclear. The aim was to investigate the effect of 3 months HEN on health related QOL and nutritional status of esophageal cancerpatients who were preoperatively malnourished. METHODS AND STUDY DESIGN: 142 malnourished (PG-SGA stage B or C) patients with esophageal cancer were assigned to receive Ivor Lewis minimally invasive esophagectomy (MIE group) with laparoscopic jejunal feeding tube placement or open esophagectomy (OE group) with nasojejunal feeding tube placement. After discharge, patients in the MIE group received HEN with 500-1000 kcal/d for 3 months, while the OE group patients did not receive HEN, as nasojejunal feeding tubes had been removed. QLQ-C30 and PG-SGA questionnaires were used to evaluate the QOL and the risk of malnutrition. RESULTS: 67 patients were enrolled in the MIE group and 75 patients were enrolled in the OE group. Symptoms related to fatigue, nausea, vomiting, pain, and appetite loss were significantly decreased in the patients treated with 3 months HEN. Similarly, patients treated with 3 months HEN had a lower risk of malnutrition than patients did not receive HEN (PG-SGA score, 5.7 vs 7.9, p<0.01). More patients in the MIE group (received 3 months HEN) were able to complete postoperative chemoradiotherapy than patients in the OE group (p<0.01). CONCLUSIONS:MIE and subsequent treatment with 3 months HEN can improve the QOL and reduce the risk of malnutrition in preoperatively malnourished patients.
Authors: Martin Wagner; Pascal Probst; Michael Haselbeck-Köbler; Johanna M Brandenburg; Eva Kalkum; Dominic Störzinger; Jens Kessler; Joe J Simon; Hans-Christoph Friederich; Michaela Angelescu; Adrian T Billeter; Thilo Hackert; Beat P Müller-Stich; Markus W Büchler Journal: Ann Surg Date: 2022-01-27 Impact factor: 13.787