Home enteral nutrition for postoperative elderly patients with esophageal cancer

Chen, Xueyu; Zhao, Guochao; Zhu, Liangjun

doi:10.21037/apm-20-2197

Cited by 15 publications

(10 citation statements)

References 12 publications

(10 reference statements)

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“…Most recently, Chen et al [ 6 ] conducted a retrospective cohort study including 60 patients undergoing oesophageal surgery (30 received HEN and 30 received conventional nutrition). In their study, enteral nutrition (EnSure ® , Abbott Laboratories, the Netherlands) was offered via the nasointestinal tube after the second postoperative day.…”

Section: Resultsmentioning

confidence: 99%

In patients undergoing oesophagectomy does postoperative home enteral nutrition have any impact on nutritional status?

Zhou

et al. 2022

Interactive CardioVascular and Thoracic Surgery

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Summary A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was ‘In patients undergoing oesophagectomy does postoperative home enteral nutrition have any impact on nutritional status’? Altogether, 50 papers were found using the reported search, of which 5 studies represented the best evidence to answer the clinical question. This consisted of one systematic review including a meta-analysis of nine randomized controlled trials (RCTs), three RCTs and one cohort study. Main outcomes included loss of body weight and body mass index (BMI), change of serum albumin, hemoglobin, total protein and prealbumin, rates of nutritional risk patients and score value of patient-generated subjective global assessment (PG-SGA). The meta-analysis concluded that there was significant differences in the loss of body weight and BMI between two groups, with higher values observed in the HEN group than that in the control group. One RCT showed that patients receiving HEN had a significantly lower weight loss compared with the control group. However, in another RCT, there was no significant difference between two group in the loss of weight and body BMI. The available evidence shows that patients receiving home enteral nutrition yielded a significantly better BMI and lower decrease of body weight than those without after surgical resection of oesophageal cancer. We conclude that HEN could serve as an effective intervention for patients undergoing oesophagectomy. Moreover, the optimal time for patients receiving HEN could be 4–8 weeks after discharge. Feeding via jejunostomy and nasointestinal tube are both feasible and safety approaches for HEN.

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Section: Resultsmentioning

confidence: 99%

In patients undergoing oesophagectomy does postoperative home enteral nutrition have any impact on nutritional status?

Zhou

et al. 2022

Interactive CardioVascular and Thoracic Surgery

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show abstract

“…The underlying mechanism may involve immune function. Enteral nutrition improves prealbumin levels in postoperative cancer patients, and increased prealbumin is strongly correlated with higher CD4 and CD8 T cell counts and immunoglobulin levels [ 33 ]. In addition, prealbumin is predominantly synthesized in the liver; therefore, a decline in prealbumin may reflect a hepatic dysfunction and abnormal anticancer drug metabolism, which is a key factor that predicts worse outcomes in GC [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Determination of Survival of Gastric Cancer Patients With Distant Lymph Node Metastasis Using Prealbumin Level and Prothrombin Time: Contour Plots Based on Random Survival Forest Algorithm on High-Dimensionality Clinical and Laboratory Datasets

et al. 2022

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Purpose This study aimed to identify prognostic factors for patients with distant lymph node-involved gastric cancer (GC) using a machine learning algorithm, a method that offers considerable advantages and new prospects for high-dimensional biomedical data exploration. Materials and Methods This study employed 79 features of clinical pathology, laboratory tests, and therapeutic details from 289 GC patients whose distant lymphadenopathy was presented as the first episode of recurrence or metastasis. Outcomes were measured as any-cause death events and survival months after distant lymph node metastasis. A prediction model was built based on possible outcome predictors using a random survival forest algorithm and confirmed by 5×5 nested cross-validation. The effects of single variables were interpreted using partial dependence plots. A contour plot was used to visually represent survival prediction based on 2 predictive features. Results The median survival time of patients with GC with distant nodal metastasis was 9.2 months. The optimal model incorporated the prealbumin level and the prothrombin time (PT), and yielded a prediction error of 0.353. The inclusion of other variables resulted in poorer model performance. Patients with higher serum prealbumin levels or shorter PTs had a significantly better prognosis. The predicted one-year survival rate was stratified and illustrated as a contour plot based on the combined effect the prealbumin level and the PT. Conclusions Machine learning is useful for identifying the important determinants of cancer survival using high-dimensional datasets. The prealbumin level and the PT on distant lymph node metastasis are the 2 most crucial factors in predicting the subsequent survival time of advanced GC. Trial Registration ChiCTR Identifier: ChiCTR1800019978

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“…Early postoperative weight decreased up to 3 months, while stabilization occurred between 4–6 months after surgery; a further decline could be prevented by continuing enteral feeding supplementation [ 16 ]. In comparison with a control group, Chen et al demonstrated in elderly patients after esophagectomy significant benefits from home enteral nutrition for at least 8 weeks for the BMI, PG-SGA score, serum albumin, and immune parameters [ 62 ].…”

Section: Post-discharge Nutritionmentioning

confidence: 99%

Oral Nutritional Supplements and Enteral Nutrition in Patients with Gastrointestinal Surgery

Wobith

Weimann

2021

Nutrients

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Nowadays, patients undergoing gastrointestinal surgery are following perioperative treatment in enhanced recovery after surgery (ERAS) protocols. Although oral feeding is supposed not to be stopped perioperatively with respect to ERAS, malnourished patients and inadequate calorie intake are common. Malnutrition, even in overweight or obese patients, is often underestimated. Patients at metabolic risk have to be identified early to confirm the indication for nutritional therapy. The monitoring of nutritional status postoperatively has to be considered in the hospital and after discharge, especially after surgery in the upper gastrointestinal tract, as normal oral food intake is decreased for several months. The article gives an overview of the current concepts of perioperative enteral nutrition in patients undergoing gastrointestinal surgery.

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Home enteral nutrition for postoperative elderly patients with esophageal cancer

Cited by 15 publications

References 12 publications

In patients undergoing oesophagectomy does postoperative home enteral nutrition have any impact on nutritional status?

In patients undergoing oesophagectomy does postoperative home enteral nutrition have any impact on nutritional status?

Determination of Survival of Gastric Cancer Patients With Distant Lymph Node Metastasis Using Prealbumin Level and Prothrombin Time: Contour Plots Based on Random Survival Forest Algorithm on High-Dimensionality Clinical and Laboratory Datasets

Oral Nutritional Supplements and Enteral Nutrition in Patients with Gastrointestinal Surgery

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