OBJECTIVE: To avoid perioperative complications caused malnutrition, nutrition therapy is necessary in gastric outlet obstruction (GOO) patients. Compared to parenteral nutrition (PN), enteral nutrition (EN) is associated with many advantages. This study aimed to investigate whether preoperative EN has beneficial clinical effects compared to preoperative PN in gastric cancer patients with GOO undergoing surgery. METHODS: According to the methods of preoperative nutrition therapy, 143 patients were divided into EN group (n=42) and PN group (n=101) between January 2013 and December 2017 at the Chinese People's Liberation Army General Hospital. Multiple logistic regression models were used to assess the association between the methods of preoperative nutrition therapy and postoperative day of flatus passage. The generalized additive model and two-piecewise linear regression model were used to calculate the inflection point of the preoperative nutritional therapy time on the postoperative day of flatus passage in the PN group. RESULTS: EN shortened the postoperative day of flatus passage in gastric cancer patients with GOO, which is a protective factor, especially in patients who underwent non-radical operations and the postoperative day of flatus passage reduced when the preoperative PN therapy was up to 3 d and a longer PN therapy (>3 d) did not accelerate the postoperative recovery of gastrointestinal functions. CONCLUSIONS: Preoperative EN therapy would benefit gastric cancer patients with GOO by accelerating postoperative recovery. For patients with absolute obstruction, no more than 3-day PN therapy is recommended if patients can tolerate general anesthesia and surgery.
OBJECTIVE: To avoid perioperative complications caused malnutrition, nutrition therapy is necessary in gastric outlet obstruction (GOO) patients. Compared to parenteral nutrition (PN), enteral nutrition (EN) is associated with many advantages. This study aimed to investigate whether preoperative EN has beneficial clinical effects compared to preoperative PN in gastric cancer patients with GOO undergoing surgery. METHODS: According to the methods of preoperative nutrition therapy, 143 patients were divided into EN group (n=42) and PN group (n=101) between January 2013 and December 2017 at the Chinese People's Liberation Army General Hospital. Multiple logistic regression models were used to assess the association between the methods of preoperative nutrition therapy and postoperative day of flatus passage. The generalized additive model and two-piecewise linear regression model were used to calculate the inflection point of the preoperative nutritional therapy time on the postoperative day of flatus passage in the PN group. RESULTS: EN shortened the postoperative day of flatus passage in gastric cancer patients with GOO, which is a protective factor, especially in patients who underwent non-radical operations and the postoperative day of flatus passage reduced when the preoperative PN therapy was up to 3 d and a longer PN therapy (>3 d) did not accelerate the postoperative recovery of gastrointestinal functions. CONCLUSIONS: Preoperative EN therapy would benefit gastric cancer patients with GOO by accelerating postoperative recovery. For patients with absolute obstruction, no more than 3-day PN therapy is recommended if patients can tolerate general anesthesia and surgery.
Authors: Jeanin E van Hooft; Marcel G W Dijkgraaf; Robin Timmer; Peter D Siersema; Paul Fockens Journal: Scand J Gastroenterol Date: 2010-10 Impact factor: 2.423
Authors: Peter Pronovost; Dale Needham; Sean Berenholtz; David Sinopoli; Haitao Chu; Sara Cosgrove; Bryan Sexton; Robert Hyzy; Robert Welsh; Gary Roth; Joseph Bander; John Kepros; Christine Goeschel Journal: N Engl J Med Date: 2006-12-28 Impact factor: 91.245
Authors: F A Moore; D V Feliciano; R J Andrassy; A H McArdle; F V Booth; T B Morgenstein-Wagner; J M Kellum; R E Welling; E E Moore Journal: Ann Surg Date: 1992-08 Impact factor: 12.969
Authors: Annika Reintam Blaser; Joel Starkopf; Waleed Alhazzani; Mette M Berger; Michael P Casaer; Adam M Deane; Sonja Fruhwald; Michael Hiesmayr; Carole Ichai; Stephan M Jakob; Cecilia I Loudet; Manu L N G Malbrain; Juan C Montejo González; Catherine Paugam-Burtz; Martijn Poeze; Jean-Charles Preiser; Pierre Singer; Arthur R H van Zanten; Jan De Waele; Julia Wendon; Jan Wernerman; Tony Whitehouse; Alexander Wilmer; Heleen M Oudemans-van Straaten Journal: Intensive Care Med Date: 2017-02-06 Impact factor: 17.440