Kong Seong-Ho, Park Jun Seok, Lee In Kyu, Ryu Seung-Wan, Park Young-Kyu, Yang Han-Kwang, Han Sang-Uk, Yoon Ki-Young, Jeong Seung-Yong, Jeong Mi Ran, Hwang Dae Wook, Suh Yun-Suhk, Yoon Yoo-Seok, Seo Kyung Won, Park Ji Won, Byun Chul-Su, Hur Hoon, Won Hojeong, Choi Yunhee, Lee Hyuk-Joon
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Department of Surgery, Kyungpook National University Medical Center, Daegu, Korea.
Asia Pac J Clin Nutr. 2017;26(5):811-819. doi: 10.6133/apjcn.112016.02.
This study aimed to evaluate the efficacy of post-operative oral nutrition supplementation after major gastrointestinal surgery.
A prospective randomized controlled trial was conducted to evaluate 174 subjects who were discharged within 2 weeks after major gastrointestinal surgery. The subjects in the study group were prescribed 400 ml/day of Encover® from the day of discharge for 8 weeks, but no supplementation was allowed in the control group. The primary endpoint was the weight loss rate at 8 weeks after discharge compared with the pre-operative weight, and the secondary endpoints included changes in body weight, body mass index, Patient-Generated Subjective Global Assessment score/grade, hematological/ biochemical parameters, and adverse events evaluated at 2, 4, and 8 weeks after discharge.
The weight loss rate at 8 weeks after discharge did not differ between two groups (4.23±5.49% vs 4.80±4.84%, p=0.481). The total lymphocyte count, the level of total cholesterol, total protein, and albumin were significantly higher in the study group after discharge. Diarrhea was the most frequent adverse event, and the incidence of adverse events with a severity score of >=3 did not differ between groups (2.3% vs 1.2%).
The utility of routine oral nutritional support after major gastrointestinal surgery was not proven in terms of weight loss at 8 weeks after discharge. However, it can be beneficial for early recovery of biochemical parameters.
本研究旨在评估胃肠大手术后口服营养补充的疗效。
进行了一项前瞻性随机对照试验,以评估174例在胃肠大手术后2周内出院的受试者。研究组受试者从出院日起每天服用400毫升能全素,持续8周,而对照组不给予补充剂。主要终点是出院后8周时的体重减轻率与术前体重相比,次要终点包括出院后2周、4周和8周时体重、体重指数、患者主观整体评估评分/等级、血液学/生化参数的变化以及不良事件。
出院后8周时两组的体重减轻率无差异(4.23±5.49%对4.80±4.84%,p=0.481)。出院后研究组的淋巴细胞总数、总胆固醇、总蛋白和白蛋白水平显著更高。腹泻是最常见的不良事件,严重程度评分≥3的不良事件发生率在两组间无差异(2.3%对1.2%)。
在出院后8周的体重减轻方面,胃肠大手术后常规口服营养支持的效用未得到证实。然而,它可能有利于生化参数的早期恢复。