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接受胃癌切除术患者行空肠造口喂养的益处。

Benefits of jejunostomy feeding in patients who underwent gastrectomy for cancer treatment.

作者信息

Jaquet Romain, Rivkine Emmanuel, De Souza Nicole, Roudié Jean

机构信息

Department of Digestive and Visceral Surgery, Nord Essonne Hospital Group - Longjumeau Site, Longjumeau 91160, France.

Department of General and Digestive Surgery, Pierre Zobda-Quitman Hospital, University Hospital Center, Martinique, France, Fort de France 97261, Martinique.

出版信息

World J Gastrointest Surg. 2024 Aug 27;16(8):2461-2473. doi: 10.4240/wjgs.v16.i8.2461.

Abstract

BACKGROUND

Gastric cancer is associated with significant undernutrition responsible for an increase in morbidity and mortality after gastrectomy.

AIM

To evaluate the impact of enteral nutrition by jejunostomy feeding in patients undergoing gastrectomy for cancer.

METHODS

Between 2003 and 2017, all patients undergoing gastrectomy for cancer treatment were included retrospectively. A group with jejunostomy (J + group) and a group without jejunostomy (J - group) were compared.

RESULTS

Of the 172 patients included, 60 received jejunostomy. Preoperatively, the two groups were comparable with respect to the nutritional parameters studied (body mass index, albumin, ). In the postoperative period, the J + group lost less weight and albumin: 5.74 ± 8.4 9.86 ± 7.5 kg ( = 0.07) and 7.2 ± 5.6 14.7 ± 12.7 g/L ( = 0.16), respectively. Overall morbidity was 25% in the J + group and 36.6% in the J - group ( = 0.12). The J + group had fewer respiratory, infectious, and grade 3 complications: 0% 5.4% ( = 0.09), 1.2% 9.3% ( = 0.03), and 0% 4.7% ( = 0.05), respectively. The 30-day mortality was 6.7% in the J + group and 6.3% in the J - group ( = 0.91).

CONCLUSION

Jejunostomy feeding after gastrectomy improves nutritional characteristics and decreases postoperative morbidity. A prospective study could confirm our results.

摘要

背景

胃癌常伴有严重营养不良,这会导致胃切除术后发病率和死亡率上升。

目的

评估空肠造口喂养肠内营养对接受胃癌胃切除术患者的影响。

方法

回顾性纳入2003年至2017年间所有接受胃癌治疗胃切除术的患者。比较有空肠造口组(J+组)和无空肠造口组(J-组)。

结果

纳入的172例患者中,60例接受了空肠造口术。术前,两组在所研究的营养参数(体重指数、白蛋白等)方面具有可比性。术后,J+组体重和白蛋白下降较少:分别为5.74±8.4比9.86±7.5kg(P=0.07)和7.2±5.6比14.7±12.7g/L(P=0.16)。J+组总体发病率为25%,J-组为36.6%(P=0.12)。J+组呼吸、感染和3级并发症较少:分别为0%比5.4%(P=0.09)、1.2%比9.3%(P=0.03)和0%比4.7%(P=0.05)。J+组30天死亡率为6.7%,J-组为算6.3%(P=0.91)。

结论

胃切除术后空肠造口喂养可改善营养状况并降低术后发病率。前瞻性研究可证实我们的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1666/11362917/e75b37f08d25/WJGS-16-2461-g001.jpg

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