First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.
Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.
J Am Coll Nutr. 2020 Sep-Oct;39(7):650-656. doi: 10.1080/07315724.2020.1723453. Epub 2020 Feb 4.
Malnutrition is common in patients who underwent upper gastrointestinal cancer surgery. Our goal was to explore postoperative compliance with oral nutritional supplementation and define barriers to consumption in patients with esophageal, gastroesophageal junction, and gastric cancer. Participants were prospectively recruited from September 2015 to November 2018. Preoperative nutritional status was assessed using the Patient Generated Subjective Global Assessment. Malnourished patients and patients at risk for malnutrition were offered oral nutritional supplementation at the time of hospital discharge. Compliance was evaluated 1 month after hospital discharge. A total of 78 patients were analyzed. Mean patient age was 62.8 ± 10.7 years and 83.3% were males. Εsophagectomy and gastrectomy were performed in 60.3% and 39.7% of the patients respectively. Twenty-eight (35.9%) participants reported consuming all prescribed supplements, whereas 50 (64.1%) patients were noncompliant with their prescribed oral nutritional supplementation regimen. The main barriers to oral nutritional supplementation compliance were bloating (compliant vs. noncompliant patients: 17.9% vs. 58%, < 0.001), early satiety (compliant vs. noncompliant patients: 25% vs. 52.32%, < 0.001), flavor or texture dislike (compliant vs. noncompliant patients: 7.1% vs. 34%, < 0.001), and diarrhea (compliant vs. noncompliant patients: 10.7% vs. 24%, < 0.001). No other statistically significant differences were identified between the two groups. Postoperative compliance to oral nutritional supplementation is low in patients who underwent upper gastrointestinal cancer surgery. Patient education and support as well as providing a range of oral nutrition supplement flavors, texture, and compositions may be useful in increasing adherence to oral nutritional supplementation regimens.
营养不良在接受上消化道癌症手术的患者中很常见。我们的目标是探讨食管癌、胃食管交界处癌和胃癌患者术后口服营养补充的依从性，并确定影响其摄入的障碍因素。研究对象于 2015 年 9 月至 2018 年 11 月期间前瞻性招募。术前营养状况采用患者生成的主观整体评估进行评估。在出院时为营养不良患者和有营养不良风险的患者提供口服营养补充剂。在出院后 1 个月评估依从性。共分析了 78 例患者。患者的平均年龄为 62.8±10.7 岁，83.3%为男性。60.3%的患者接受了食管切除术，39.7%的患者接受了胃切除术。28 名（35.9%）参与者报告服用了所有规定的补充剂，而 50 名（64.1%）患者未按规定服用口服营养补充剂。口服营养补充依从性的主要障碍是腹胀（依从性与非依从性患者：17.9%比 58%， < 0.001）、早饱（依从性与非依从性患者：25%比 52.32%， < 0.001）、口味或质地不喜欢（依从性与非依从性患者：7.1%比 34%， < 0.001）和腹泻（依从性与非依从性患者：10.7%比 24%， < 0.001）。两组之间没有其他统计学上的显著差异。接受上消化道癌症手术的患者术后口服营养补充的依从性较低。对患者进行教育和支持，以及提供多种口味、质地和成分的口服营养补充剂，可能有助于提高患者对口服营养补充剂方案的依从性。
