J Sand1, M Luostarinen, M Matikainen. 1. Department of Surgery, Tampere University Hospital and Medical School, Tampere University, Finland. juhsan@sgic.fi
Abstract
OBJECTIVE: To compare the efficacy and cost of enteral and parenteral feeding after total gastrectomy. DESIGN: Prospective randomised open study. SETTING: University hospital, Finland. SUBJECTS:29 patients undergoing curative total gastrectomy for gastric cancer. INTERVENTIONS:13 patients were givenearly enteral feeding by nasojejunal tube and 16 patients parenteral nutrition by central venous catheter. MAIN OUTCOME MEASURES: Postoperative complications, duration of hospital stay, serum CRP and albumin concentrations, cost, and postoperative abdominal symptoms. RESULTS: One patient in the enteral feeding group discontinued the study on day 1. Oesophagojejunal leaks developed in one patient in each group. Infective complications occurred in 3 (23%) in the enteral group and 5 (31%) in the parenteral group. Serum CRP concentration on day six was lower in the enteral feeding group than in the parenteral feeding group (32 (16) g/L compared with 61 (41) g/L; p = 0.02). Enteral feeding was well tolerated. Diarrhoea developed earlier in the enteral than in the parenteral group (days 3-5 compared with 5-7, respectively) but there was a tendency to an increased risk of diarrhoea in the parenteral group. Parenteral feeding was more than four times as expensive as enteral feeding. CONCLUSION:Enteral nasojejunal feeding is safe and well tolerated after total gastrectomy. It is also cheaper than parenteral nutrition.
RCT Entities:
OBJECTIVE: To compare the efficacy and cost of enteral and parenteral feeding after total gastrectomy. DESIGN: Prospective randomised open study. SETTING: University hospital, Finland. SUBJECTS: 29 patients undergoing curative total gastrectomy for gastric cancer. INTERVENTIONS: 13 patients were given early enteral feeding by nasojejunal tube and 16 patients parenteral nutrition by central venous catheter. MAIN OUTCOME MEASURES: Postoperative complications, duration of hospital stay, serum CRP and albumin concentrations, cost, and postoperative abdominal symptoms. RESULTS: One patient in the enteral feeding group discontinued the study on day 1. Oesophagojejunal leaks developed in one patient in each group. Infective complications occurred in 3 (23%) in the enteral group and 5 (31%) in the parenteral group. Serum CRP concentration on day six was lower in the enteral feeding group than in the parenteral feeding group (32 (16) g/L compared with 61 (41) g/L; p = 0.02). Enteral feeding was well tolerated. Diarrhoea developed earlier in the enteral than in the parenteral group (days 3-5 compared with 5-7, respectively) but there was a tendency to an increased risk of diarrhoea in the parenteral group. Parenteral feeding was more than four times as expensive as enteral feeding. CONCLUSION: Enteral nasojejunal feeding is safe and well tolerated after total gastrectomy. It is also cheaper than parenteral nutrition.
Authors: Ronald Chow; Eduardo Bruera; Jann Arends; Declan Walsh; Florian Strasser; Elisabeth Isenring; Egidio G Del Fabbro; Alex Molassiotis; Monica Krishnan; Leonard Chiu; Nicholas Chiu; Stephanie Chan; Tian Yi Tang; Henry Lam; Michael Lock; Carlo DeAngelis Journal: Support Care Cancer Date: 2019-12-07 Impact factor: 3.603
Authors: A Weimann; Ch Ebener; S Holland-Cunz; K W Jauch; L Hausser; M Kemen; L Kraehenbuehl; E R Kuse; F Laengle Journal: Ger Med Sci Date: 2009-11-18