Takebayashi Katsushi, Kaida Sachiko, Yamaguchi Tsuyoshi, Otake Reiko, Miyake Toru, Kojima Masatsugu, Iida Hiroya, Maehira Hiromitsu, Mori Haruki, Bamba Shigeki, Shimizu Tomoharu, Sasaki Masaya, Tani Masaji
Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
Division of Clinical Nutrition, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan.
Dis Esophagus. 2023 Feb 24;36(3). doi: 10.1093/dote/doac052.
Body weight loss and poor nutritional status are frequently observed after esophageal cancer surgery. The aim of this study was to pilot an investigation on the impact of home enteral tube feeding supplementation (HES) for up to 3 months after esophageal cancer surgery. We retrospectively reviewed consecutive 67 esophageal cancer patients who underwent esophagectomy with gastric tube reconstruction. We started HES from April 2017. The patients were divided into 2 groups. Among 67 patients, 40 patients underwent HES between April 2017 and November 2020 (HES group). Other 27 patients who underwent esophagectomy between January 2012 and March 2017 were not administered HES (C group). Thereafter, multiple factors concerning patient nutritional status at long-term follow-up were evaluated. The baseline characteristics were balanced between the two groups. There were no significant differences in nutritional status scores before esophagectomy. The percentage weight loss was less in the HES group compared with the C group both at 3 months and 1 year after surgery: 7.3% (-7.6 to 15.2), 7.7% (-4 to 13.9) in the HES group and 10.6% (-3.6 to 29.1), 10.8% (-5.8 to 20.0) in C group (P < 0.05, P < 0.05). In the patients with anastomotic stenosis, the percentage weight loss was less in the HES group compared with the C group: 7.2% (2.0-14.9) and 14.6% (6.2-29.1), P < 0.05. HES may improve early weight loss in postesophagectomy patients.
食管癌手术后经常会出现体重减轻和营养状况不佳的情况。本研究的目的是对食管癌手术后长达3个月的家庭肠内管饲补充(HES)的影响进行初步调查。我们回顾性分析了连续67例行食管切除术并胃管重建的食管癌患者。我们从2017年4月开始进行HES。患者分为2组。在67例患者中,40例在2017年4月至2020年11月期间接受了HES(HES组)。其他27例在2012年1月至2017年3月期间行食管切除术的患者未接受HES(C组)。此后,对长期随访中患者营养状况的多个因素进行了评估。两组之间的基线特征均衡。食管切除术前营养状况评分无显著差异。术后3个月和1年时,HES组的体重减轻百分比均低于C组:HES组分别为7.3%(-7.6至15.2)、7.7%(-4至13.9),C组分别为10.6%(-3.6至29.1)、10.8%(-5.8至20.0)(P<0.05,P<0.05)。在吻合口狭窄的患者中,HES组的体重减轻百分比低于C组:分别为7.2%(2.0 - 14.9)和14.6%(6.2 - 29.1),P<0.05。HES可能改善食管切除术后患者的早期体重减轻情况。