Shen Yi, Zhou Yunfeng, He Tao, Zhuang Xiang
Department of Thoracic Surgery, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
Department of Thoracic Surgery, The 2nd Affiliated Hospital of Chengdu Medical College, Chengdu, China.
Nutr Cancer. 2021;73(4):596-601. doi: 10.1080/01635581.2020.1764981. Epub 2020 May 13.
Patients with esophageal cancer are often accompanied by malnutrition, especially in patients with obvious swallowing tract. Many studies have shown that preoperative nutritional support can reduce postoperative complications, but there are few studies comparing preoperative enteral nutrition with intravenous nutrition. The aim of the study was to compare the effects of the two nutritional support path in esophageal cancer patients undergoing surgery. We used the nutritional risk screening 2002 (NRS2002) for preoperative nutritional risk screening in patients with esophageal cancer treated at our department between April 2016 and March 2019. A total of 56 patients with an NRS2002 score ≥ 3 and with apparent difficulty swallowing received preoperative parenteral nutrition (PN; = 29) or enteral nutrition (EN; = 27). Both groups received 7 day of nutritional support before surgery. Nutritional indicators were measured on preoperative day 7, preoperative day 1, and postoperative day 7. The baseline characteristics, perioperative condition, nutritional status, and postoperative complications of the two groups were compared and analysed. There was no significant difference in baseline characteristics and perioperative nutrition indicators between two groups. Postoperative hospital stay and the costs of nutrition support were significantly reduced in the EN group compared with PN group ( = 0.000). The times of first passing gas and bowel movement were shorter in the EN group compared with PN group ( = 0.001). The incidence of gastrointestinal complications was lower in the EN group compared with PN group ( = 0.039). For esophageal cancer patients with an NRS2002 score ≥ 3 and apparent difficulty swallowing, preoperative EN with a gastric tube is safe and easy to perform. Preoperative EN can shorten the recovery time of gastrointestinal function, reduce the incidence of gastrointestinal complications, finally accelerate postoperative recovery.
食管癌患者常伴有营养不良，尤其是吞咽困难明显的患者。许多研究表明，术前营养支持可减少术后并发症，但比较术前肠内营养与静脉营养的研究较少。本研究的目的是比较两种营养支持途径对食管癌手术患者的影响。我们使用营养风险筛查2002（NRS2002）对2016年4月至2019年3月在我科接受治疗的食管癌患者进行术前营养风险筛查。共有56例NRS2002评分≥3且吞咽明显困难的患者接受了术前肠外营养（PN；n = 29）或肠内营养（EN；n = 27）。两组均在术前接受7天的营养支持。在术前第7天、术前第1天和术后第7天测量营养指标。比较并分析两组的基线特征、围手术期情况、营养状况和术后并发症。两组之间的基线特征和围手术期营养指标无显著差异。与PN组相比，EN组的术后住院时间和营养支持费用显著降低（P = 0.000）。与PN组相比，EN组首次排气和排便时间更短（P = 0.001）。与PN组相比，EN组胃肠道并发症的发生率更低（P = 0.039）。对于NRS2002评分≥3且吞咽明显困难的食管癌患者，术前经胃管给予EN安全且易于实施。术前EN可缩短胃肠功能恢复时间，降低胃肠道并发症的发生率，最终加速术后康复。
