Sonoi Mika, Shirakawa Yasuhiro, Sonoi Norihiro, Noma Kazuhiro, Tanabe Shunsuke, Maeda Naoaki, Morimatsu Hiroshi
Department of Foods and Human Nutrition, Faculty of Human Life Sciences, Notre Dame Seishin University, Okayama, Japan.
Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
Asian Pac J Cancer Prev. 2025 Jan 1;26(1):263-267. doi: 10.31557/APJCP.2025.26.1.263.
This study aimed to clarify whether nutritional status at admission affects enteral nutrition weaning 6 months after surgery in patients with esophageal cancer.
This was a retrospective study of 81 patients who underwent subtotal esophageal cancer resection between April 2014 and February 2016. The survey items were as follows: 1) sex, 2) age, 3) presence or absence of family members living together, 4) clinical stage, 5) surgical procedure, 6) reconstructed organs, 7) nutritional status at admission, 8) presence or absence of postoperative complications (anastomotic leakage, chylothorax, and recurrent laryngeal nerve paralysis), and 9) presence or absence of treatment other than surgery (chemo- or radiotherapy).
The enteral nutrition withdrawal rate after 6 months was 15.5% in the malnutrition group and 84.5% in the normal nutrition group (p = 0.007). In a comparison between groups with and without enteral nutrition after 6 months, a significant association was observed with surgical procedure, nutritional status at admission, and postoperative complications (p < 0.05). Logistic regression analysis showed that the odds of discontinuing enteral nutrition 6 months later were 5.692 (hazard ratio: 1.545-20.962) for malnutrition on admission and 11.921 (hazard ratio: 3.449-41.207) for complications.
Regardless of the presence or absence of treatment other than surgery, preoperative nutritional improvement is beneficial for increasing postoperative oral intake.
本研究旨在阐明食管癌患者入院时的营养状况是否会影响术后6个月肠内营养的撤机情况。
这是一项对2014年4月至2016年2月期间接受食管癌次全切除术的81例患者的回顾性研究。调查项目如下:1)性别,2)年龄,3)是否有共同居住的家庭成员,4)临床分期,5)手术方式,6)重建器官,7)入院时的营养状况,8)术后并发症(吻合口漏、乳糜胸和喉返神经麻痹)的有无,9)是否有手术以外的治疗(化疗或放疗)。
营养不良组6个月后的肠内营养撤机率为15.5%,正常营养组为84.5%(p = 0.007)。在6个月后有或没有肠内营养的组间比较中,观察到与手术方式、入院时的营养状况和术后并发症有显著关联(p < 0.05)。逻辑回归分析显示,入院时营养不良6个月后停止肠内营养的几率为5.692(风险比:1.545 - 20.962),并发症的几率为11.921(风险比:3.449 - 41.207)。
无论是否有手术以外的治疗,术前改善营养状况有利于增加术后经口摄入量。