Department of General and Digestive Surgery, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinadamachi, Kahoku 920-0293, Ishikawa, Japan.
Department of Gastrointestinal Surgery, Kanazawa University, 13-1 Takara-Machi, Kanazawa 920-8641, Ishikawa, Japan.
Nutrients. 2024 Jul 3;16(13):2126. doi: 10.3390/nu16132126.
A useful perioperative nutritional therapy for highly invasive esophageal cancer surgical cases needs to be developed. We clarified the usefulness of amino-acid-enriched nutritional therapy using glutamine (Gln)/arginine (Arg)/calcium β-hydroxy-β-methylbutyrate (HMB) products on the short-term postoperative outcomes of minimally invasive esophagectomy for esophageal cancer. Altogether, 114 patients (Gln/Arg/HMB group) received perioperative nutritional therapy with Gln/Arg/HMB products, and we retrospectively investigated the change in nutritional parameters including skeletal muscle mass, occurrence of postoperative complications, and short-term postoperative outcomes in this group. The results were compared between the Gln/Arg/HMB and control groups (79 patients not receiving the Gln/Arg/HMB products). The incidence of all postoperative complications, sputum expectoration disorder, and pleural effusion of grade ≥ III was significantly lower in the Gln/Arg/HMB group (62.0% vs. 38.6%, = 0.001; 44.3% vs. 28.1%, = 0.020; 27.8% vs. 13.2%, = 0.011, respectively). The psoas muscle area and postoperative body weight were significantly higher at 1 month and 1 year after surgery in the Gln/Arg/HMB group than in the control group (93.5% vs. 99.9%, < 0.001; 92.0% vs. 95.4%, = 0.006). Perioperative amino-acid-enriched nutritional therapy may improve the short-term postoperative outcomes, nutritional status, and skeletal muscle mass of esophageal cancer surgical patients.
需要开发一种针对高度侵袭性食管癌手术病例的有效的围手术期营养治疗方法。我们阐明了使用富含谷氨酰胺(Gln)/精氨酸(Arg)/β-羟基-β-甲基丁酸钙(HMB)产品的氨基酸增强型营养治疗对微创食管癌手术后短期结局的有用性。共有 114 例(Gln/Arg/HMB 组)患者接受了 Gln/Arg/HMB 产品的围手术期营养治疗,我们回顾性研究了该组患者的营养参数变化,包括骨骼肌量、术后并发症的发生以及短期术后结局。将结果与 Gln/Arg/HMB 组(未接受 Gln/Arg/HMB 产品的 79 例患者)进行比较。Gln/Arg/HMB 组的所有术后并发症、咳痰障碍和 III 级以上胸腔积液的发生率明显低于对照组(62.0%比 38.6%,=0.001;44.3%比 28.1%,=0.020;27.8%比 13.2%,=0.011)。Gln/Arg/HMB 组术后 1 个月和 1 年时的腰大肌面积和术后体重明显高于对照组(93.5%比 99.9%,<0.001;92.0%比 95.4%,=0.006)。围手术期氨基酸增强型营养治疗可能改善食管癌手术患者的短期术后结局、营养状况和骨骼肌量。