Mendivil Alberto A, Rettenmaier Mark A, Abaid Lisa N, Brown John V, Mori Kristina M, Goldstein Bram H
Gynecologic Oncology Associates, 351 Hospital Road, Suite #507, Newport Beach, CA, 92663, USA.
Arch Gynecol Obstet. 2017 Feb;295(2):439-444. doi: 10.1007/s00404-016-4227-2. Epub 2016 Nov 10.
Total parenteral nutrition (TPN) presumably benefits cancer patients although reports have disputed the significance of this nutritional intervention. We sought to compare the postoperative outcomes of ovarian cancer patients treated with either TPN or conservative management.
We retrospectively evaluated the impact of TPN and conservative management in ovarian cancer patients who underwent debulking surgery and a bowel resection. The primary study variables encompassed patient time until restoration of bowel function, number of postoperative complications and duration of hospital stay.
There were 147 subjects who were selected for this study. The patients who were treated with TPN (n = 69) demonstrated a longer time until restoration of bowel function (5.77 vs. 4.70 days; P < 0.001), experienced lower pre-operative albumin levels (2.22 vs. 2.97 g/dL; P < 0.001) and endured a significantly longer hospital stay (11.46 vs. 7.14 days; P < 0.001) compared to the conservative management (n = 78) cohort.
Postoperative TPN in ovarian cancer patients may be inadvisable because of the increased risk for complications. Moreover, in the hypoalbuminemic patients, TPN may have not only delayed their postoperative recovery and increased hospital stay duration, but further precipitated the manifestation of nosocomial sequelae.
全胃肠外营养（TPN）可能对癌症患者有益，尽管有报告对这种营养干预的重要性提出了质疑。我们试图比较接受TPN治疗或保守治疗的卵巢癌患者的术后结局。
我们回顾性评估了TPN和保守治疗对接受肿瘤细胞减灭术和肠切除术的卵巢癌患者的影响。主要研究变量包括患者恢复肠功能的时间、术后并发症的数量和住院时间。
本研究共纳入147名受试者。与保守治疗组（n = 78）相比，接受TPN治疗的患者（n = 69）恢复肠功能的时间更长（5.77天对4.70天；P < 0.001），术前白蛋白水平更低（2.22 g/dL对2.97 g/dL；P < 0.001），住院时间显著更长（11.46天对7.14天；P < 0.001）。
由于并发症风险增加，卵巢癌患者术后使用TPN可能不可取。此外，对于低白蛋白血症患者，TPN不仅可能延迟其术后恢复并延长住院时间，还可能进一步促使医院感染后遗症的出现。
