Kuang Xuechun, She Guie, Shi Yanhui, Yang Zhiyou, Li Jun, Zhang Zhipeng
Department of Geratology Surgery, Xiangya Hospital, Central South University, Changsha, China.
Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, China.
Gland Surg. 2022 May;11(5):818-825. doi: 10.21037/gs-22-170.
Pseudomyxoma peritonei (PMP) is a rare malignancy, and many uncertainties regarding its treatment and prognosis still remain. The main treatment for PMP is cytoreductive surgery (CRS) combined with heated intraperitoneal chemotherapy (HIPEC), which can lead to intra-abdominal trauma and systemic reactions. Enteral nutrition (EN) is an important and beneficial perioperative option for major complicated abdominal surgery compared with total parenteral nutrition (TPN). However, the role of EN in PMP after surgery is still unknown. The purpose of this study was to analyze the effects of EN on postoperative outcomes in PMP patients.
The perioperative clinical data of PMP patients from Xiangya Hospital of Central South University who accepted CRS plus HIPEC from January 2011 to December 2018 were collected and analyzed. The effects of EN on the nutritional status, postoperative complications, and hospital stay time of patients with PMP were studied. We further analyzed the risk factors affecting hospital stay and complications in PMP patients after surgery.
A total of 51 PMP patients accepted CRS and were enrolled in this study, including 25 cases in the EN group and 26 patients in the TPN group. The baseline demographic characteristics and preoperative nutritional status were not significantly different between the two groups. The postoperative absolute lymphocyte count (P<0.001), hemoglobin (P=0.016), and albumin (P<0.001) levels of the EN group were higher than those of the TPN group, but the postoperative hospital stay time (P=0.008) and the complication rate (P=0.03) in the EN group were less than those in the TPN group. Logistic regression analysis showed that age (P=0.031), American Society of Anesthesiologists (ASA) score (P=0.008), and EN (P=0.024) were independent risk factors for postoperative hospital stay in PMP patients. ASA score (P=0.006), number of prior operations (P=0.021), and EN (P=0.035) were independent risk factors for postoperative complications in PMP patients.
EN support results in better outcomes and is an independent protective factor for the postoperative hospital stay time and complications of PMP patients.
腹膜假黏液瘤（PMP）是一种罕见的恶性肿瘤，其治疗和预后仍存在许多不确定性。PMP的主要治疗方法是减瘤手术（CRS）联合热灌注化疗（HIPEC），这可能导致腹腔内创伤和全身反应。与全肠外营养（TPN）相比，肠内营养（EN）是重大复杂腹部手术围手术期重要且有益的选择。然而，EN在PMP术后的作用仍不清楚。本研究的目的是分析EN对PMP患者术后结局的影响。
收集并分析2011年1月至2018年12月在中南大学湘雅医院接受CRS加HIPEC的PMP患者的围手术期临床资料。研究EN对PMP患者营养状况、术后并发症及住院时间的影响。我们进一步分析了影响PMP患者术后住院时间和并发症的危险因素。
共有51例PMP患者接受CRS并纳入本研究，其中EN组25例，TPN组26例。两组患者的基线人口统计学特征和术前营养状况无显著差异。EN组术后绝对淋巴细胞计数（P < 0.001）、血红蛋白（P = 0.016）和白蛋白（P < 0.001）水平高于TPN组，但EN组术后住院时间（P = 0.008）和并发症发生率（P = 0.03）低于TPN组。Logistic回归分析显示，年龄（P = 0.031）、美国麻醉医师协会（ASA）评分（P = 0.008）和EN（P = 0.024）是PMP患者术后住院时间的独立危险因素。ASA评分（P = 0.006）、既往手术次数（P = 0.021）和EN（P = 0.035）是PMP患者术后并发症的独立危险因素。
EN支持可带来更好的结局，是PMP患者术后住院时间和并发症的独立保护因素。
