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中国一家大型学术大学医院行胰体尾切除术或胰腺肿瘤剜除术后早期肠内营养对胰瘘和远期预后的影响:一项单中心随机对照试验方案。

Effects of early enteral nutrition on pancreatic fistula and long-term prognosis after distal pancreatectomy or enucleation of pancreatic tumours in a major academic university hospital in China: protocol for a single-centre randomised controlled trial.

机构信息

Department of General Surgery, Peking University Third Hospital, Beijing, Beijing, China.

Department of General Surgery, Peking University Third Hospital, Beijing, Beijing, China

出版信息

BMJ Open. 2023 Aug 10;13(8):e068469. doi: 10.1136/bmjopen-2022-068469.

Abstract

INTRODUCTION

Postoperative pancreatic fistula (POPF) remains one of the main complications following pancreatic resection. Despite pancreatic fistula having a low postoperative mortality rate, the readmission and intervention rates in patients with pancreatic fistula are still considerable. Although there are several studies on pancreatic fistula development after pancreaticoduodenectomy, there are only a few studies on the feeding protocols applied after distal pancreatectomy or enucleation of pancreatic tumours. We designed this trial to test the hypothesis that early feeding does not increase the incidence of POPF and positively influences the long-term prognosis in patients who undergo distal pancreatectomy or enucleation of pancreatic tumours.

METHODS AND ANALYSIS

This is a prospective randomised controlled trial that will be conducted in a single centre. A total of 106 patients undergoing distal pancreatectomy or enucleation of pancreatic tumours will be recruited after providing informed consent. They will be randomly assigned to either an early or late feeding group. The early feeding group will begin enteral nutrition on postoperative day (POD) 3, and the late feeding group will begin enteral nutrition on POD7. The primary outcome is the incidence of POPF. The secondary outcomes include the length of postoperative hospital stay, postoperative complications, and indicators of long-term prognosis.

ETHICS AND DISSEMINATION

Peking University Third Hospital Medical Science Research Ethics Committee approved the study (M2021395). Findings will be disseminated in a peer-reviewed journal and in national and/or international meetings to guide future practice.

TRIAL REGISTRATION NUMBER

ChiCTR2100053978.

摘要

简介

胰十二指肠切除术后胰瘘(POPF)仍然是胰腺切除术后的主要并发症之一。尽管胰瘘的术后死亡率较低,但发生胰瘘的患者的再入院率和介入率仍然相当高。尽管有许多关于胰十二指肠切除术后胰瘘发展的研究,但只有少数关于胰体尾切除或胰腺肿瘤剜除术后应用的喂养方案的研究。我们设计了这项试验来检验以下假设:早期喂养不会增加 POPF 的发生率,并对接受胰体尾切除或胰腺肿瘤剜除术的患者的长期预后产生积极影响。

方法和分析

这是一项将在单一中心进行的前瞻性随机对照试验。共有 106 例接受胰体尾切除或胰腺肿瘤剜除术的患者在获得知情同意后将被招募。他们将被随机分配到早期或晚期喂养组。早期喂养组将在术后第 3 天开始肠内营养,晚期喂养组将在术后第 7 天开始肠内营养。主要结局是 POPF 的发生率。次要结局包括术后住院时间、术后并发症以及长期预后指标。

伦理与传播

北京大学第三医院医学科学研究伦理委员会批准了这项研究(M2021395)。研究结果将发表在同行评议的期刊上,并在国内外会议上进行传播,以指导未来的实践。

试验注册号

ChiCTR2100053978。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5373/10423769/c96a9466cf23/bmjopen-2022-068469f01.jpg

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