Capellá G, Ruiz J M, Hidalgo L, Alonso M, Salvador R, Cardona D
Servicio de Cirugía General y del Aparato Digestivo, Hospital de la Santa Cruz y San Pablo.
Nutr Hosp. 1990 Sep-Oct;5(5):317-21.
A prospective study is presented in which the impact of total parenteral nutrition (TNP) was analyzed in a group of 27 patients that underwent total gastrectomy due to gastric carcinoma (TGGC). Patients were randomly divided into two groups: Group I was formed by 15 patients and was treated systematically with TPN during the immediate postoperative period (POTPN). Group II was formed by 12 patients who were treated with conventional serum therapy during the immediate postoperative period. TPN was administered if enteral nutrition was not viable and/or patients presented complications. Both groups were similar regarding age, sex, previous illness, previous nutritional status (Preop PNI) and surgical technique used in GI transit reconstruction. Morbidity and mortality rates, nutritional status (PNI 5 days postop) and mean hospital stay were analyzed in both groups. Likewise, a retrospective comparison was made between the results obtained from this trial and those from a group of 44 patients with gastric carcinoma who underwent TGGC at our hospital a decade earlier and did not received TPN during the immediate postoperative period on a routine basis. When both series and Groups I and II were compared significant differences in mean hospital stay were observed in favor of Group I treated with routine TPN in the immediate postoperative period. There were no differences in the mortality rate when all groups were compared. It was concluded that TPN was useful in patients undergoing TGGC because it reduced postoperative mortality rate, decreased mean hospital stay and showed good cost/effectiveness correlation.
本文介绍了一项前瞻性研究，分析了全胃肠外营养（TNP）对一组因胃癌接受全胃切除术（TGGC）的27例患者的影响。患者被随机分为两组：第一组由15例患者组成，在术后即刻（POTPN）接受系统性TPN治疗。第二组由12例患者组成，在术后即刻接受传统血清疗法治疗。如果肠内营养不可行和/或患者出现并发症，则给予TPN。两组在年龄、性别、既往疾病、既往营养状况（术前PNI）和胃肠道转运重建所采用的手术技术方面相似。分析了两组的发病率和死亡率、营养状况（术后5天的PNI）和平均住院时间。同样，对本试验结果与十年前在我院接受TGGC且术后即刻未常规接受TPN的44例胃癌患者的结果进行了回顾性比较。当比较两个系列以及第一组和第二组时，观察到平均住院时间存在显著差异，有利于术后即刻接受常规TPN治疗的第一组。比较所有组时，死亡率没有差异。得出的结论是，TPN对接受TGGC的患者有用，因为它降低了术后死亡率，缩短了平均住院时间，并显示出良好的成本/效益相关性。
