Han Hongyu, Pan Meixia, Tao Yang, Liu Runzhong, Huang Zhiliang, Piccolo Korinne, Zhong Caiyun, Liu Ranyi
a Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine , Guangzhou , China.
b Fox Chase Cancer Center, Temple University , Philadelphia , Pennsylvania , USA.
Nutr Cancer. 2018 Feb-Mar;70(2):221-228. doi: 10.1080/01635581.2018.1412477. Epub 2018 Jan 9.
We retrospectively examined a large cohort of esophageal carcinoma patients who received early enteral nutrition (EEN) to clarify the validity of EEN compared with total parenteral nutrition (TPN). Included were a total of 665 consecutive patients with histologically confirmed carcinoma of the esophagus or esophagogastric junction; and all patients underwent esophagectomy. The patients were divided into two groups: TPN (n = 262) and EEN (n = 403). The TPN group consisted of patients who only received intravenous nutrition support after operation. The postoperative length of hospital stay (PLOS), anastomotic leakage, mortality after surgery, and hospital charges were reviewed and analyzed. Compared with the TPN group, the EEN group had significantly shorter mean PLOS (15.6 days vs. 22.5 days; P < 0.01). Multivariable linear regression analysis revealed EEN to be associated with shorter PLOS even after adjustment for tumor histology, tumor location, type of esophagectomy, and postoperative albumin infusion. Hospital charges were also significantly less for those in the EEN group than the TPN group. There was no significant difference between the two groups regarding the complication of anastomotic leakage and clinical outcome after surgery. These findings suggest that EEN reduces PLOS and hospital charges of Chinese esophageal cancer patients who had an esophagectomy.
我们回顾性研究了一大群接受早期肠内营养(EEN)的食管癌患者,以阐明EEN与全胃肠外营养(TPN)相比的有效性。纳入的患者共有665例经组织学确诊的食管癌或食管胃交界癌患者;所有患者均接受了食管切除术。患者分为两组:TPN组(n = 262)和EEN组(n = 403)。TPN组由术后仅接受静脉营养支持的患者组成。对术后住院时间(PLOS)、吻合口漏、术后死亡率和住院费用进行了回顾和分析。与TPN组相比,EEN组的平均PLOS显著缩短(15.6天对22.5天;P < 0.01)。多变量线性回归分析显示,即使在调整肿瘤组织学、肿瘤位置、食管切除类型和术后白蛋白输注后,EEN仍与较短的PLOS相关。EEN组的住院费用也显著低于TPN组。两组在吻合口漏并发症和术后临床结局方面无显著差异。这些发现表明,EEN可缩短接受食管切除术的中国食管癌患者的PLOS和住院费用。