Is postoperative early enteral nutrition with regular or disease-specific enteral formula really beneficial in patients undergoing esophagectomy?

Sakurai, Yoshinori; Kanaya, Shigehiko; Komori, Yoshiyuki; Uyama, Ichiro

doi:10.1007/s10388-009-0196-x

Cited by 6 publications

(7 citation statements)

References 56 publications

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“…• Animal studies have defined EEN as nutrition initiating within 36 hours after surgical insult. Clinical data show that electromyogram activity of the intestine appears 4-8 hours after surgical insult, which should guarantee the safety of EEN [13]. As previously discussed, Gabor's study [9] further demonstrates the safety of EEN and shows that providing EN 6-hour post-operative does not contribute to medical risk.…”

Section: Timing Of Feedingmentioning

confidence: 75%

Nutritional Considerations After Gastrectomy and Esophagectomy for Malignancy

Baker

Wooten

Malloy

2011

Curr. Treat. Options in Oncol.

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This article reviews various methods of assessing and managing post-gastrectomy or esophagectomy patients from a nutritional standpoint, by examining recent research focusing on assessment models, components of enteral feeding, timing of feeding, safety of enteral nutrition (EN) vs total parenteral nutrition (TPN), appetite stimulants, alternative treatments, and long-term care. Pre-, peri-, and post-operative nutrition represent a major prognostic indicator in patients undergoing a gastrectomy or esophagectomy for malignant cancer. An accurate initial nutrition assessment to determine risk, followed by close monitoring pre-operatively and early enteral feeding post-operatively, has been shown to have the most beneficial effects. The optimal delivery route for nutrition involves the use of EN with immune enhancing nutrients while avoiding TPN. In practice, TPN is reserved for patients with post-operative complications that delay enteral feeding for an extended time. While megace is commonly used as an appetite stimulant, the hormone ghrelin is another novel, safe, and efficacious treatment to improve appetite, increase by mouth (PO) intake, and minimize loss of weight and lean body mass. Although use of ghrelin is not yet common practice, as more studies are published, we predict that this will become a more common treatment. While complementary and alternative therapies are commonly employed in this patient population, more research needs to be done before incorporation into our mainstay of treatment. Long term, these patients continue to be at nutritional risk and therefore should be followed to optimize weight maintenance and prevent micronutrient deficiencies.

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Section: Timing Of Feedingmentioning

confidence: 75%

Nutritional Considerations After Gastrectomy and Esophagectomy for Malignancy

Baker

Wooten

Malloy

2011

Curr. Treat. Options in Oncol.

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“…Enteral feeding is useful not only for acute perioperative management [7], but for long-term palliative care [17], particularly for the patients with dysphagia. In the present case, PEG was placed in the early phase of the clinical course, and continuous enteral nutrition was quite effective not only for improving but for maintaining nutritional status before and after chemoradiation therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Advanced esophageal carcinoma often causes esophageal stenosis and/or an esophagobronchial fi stula, with the inability to take food orally, and therefore therapeutic measures such as surgery and/or chemoradiation therapy occasionally cause malnutrition, resulting in increased morbidity and mortality [3][4][5][6]. In this regard, perioperative use of enteral nutrition has been shown to improve nutritional status and to reduce the incidence of postoperative complications [7]. Nutritional management thus plays an important role in maintaining nutritional status and quality of life during the course of therapeutic measures in patients with advanced and recurrent esophageal carcinoma associated debilitated disorders.…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary therapeutic approach for maintaining long-term nutritional status for patient with advanced esophageal carcinoma confounded by dermatomyositis

et al. 2010

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We report a patient with advanced esophageal carcinoma associated with dermatomyositis who successfully maintained long-term good nutritional status by chemoradiation therapy and continuous enteral nutrition. A 64-year-old Japanese man was admitted to our hospital because of dysphagia and systemic edema. Because of debilitated status and malnutrition, intravenous corticosteroid infusion was fi rst performed. Continuous enteral nutrition was performed through percutaneous endoscopic gastrostomy, and chemoradiation therapy was then performed. Although the endoscopic examination revealed complete regression of esophageal carcinoma, an esophagobronchial fi stula was formed. The patient was periodically followed up by a multidisciplinary team for appropriate nutritional management; as a result, nutritional status was markedly improved and well maintained. A covered, selfexpandable metallic stent was placed in the esophagus to conceal the esophagobronchial fi stula. This case highlights the importance of multidisciplinary therapeutic approach for maintaining good nutritional status and quality of life in patients with advanced esophageal carcinoma confounded by debilitating disorders.

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“…ASPEN [ 13 ] suggested that ideal enteral nutrition should begin within 24 to 48 h after surgery. Actually, intestine had recovered its absorption function and EMG activity within 4 to 8 h after surgery [ 14 ]. The gastrointestinal tract can not only absorb nutrients, but also plays an important role in immunity because it is a central organ after surgical stress [ 15 ] and it is also the motor of the MODS.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Early Post-Operative Soluble Dietary Fiber Enteral Nutrition for Colon Cancer

et al. 2016

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We examined colon cancer patients who received soluble dietary fiber enteral nutrition (SDFEN) to evaluate the feasibility and potential benefit of early SDFEN compared to EN. Sixty patients who were confirmed as having colon cancer with histologically and accepted radical resection of colon cancer were randomized into an SDFEN group and an EN group. The postoperative complications, length of hospital stay (LOH), days for first fecal passage, and the difference in nutritional status, immune function and inflammatory reaction between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test and the chi square test. Statistical significance was defined as p < 0.05. After the nutrition support, differences in the levels of albumin, prealbumin and transferrin in each group were not statistically significant (p > 0.05); the levels of CD4+, IgA and IgM in the SDFEN group were higher than that of the EN group at seven days (p < 0.05); the levels of TNF-α and IL-6 in the SDFEN group were lower than that of the EN group at seven days (p < 0.05); and patients in the SDFEN group had a significantly shorter first flatus time than the EN group (p < 0.05). Early post-operative SDFEN used in colon cancer patients was feasible and beneficial in immune function and reducing inflammatory reaction, gastrointestinal function and speeding up the recovery.

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Is postoperative early enteral nutrition with regular or disease-specific enteral formula really beneficial in patients undergoing esophagectomy?

Cited by 6 publications

References 56 publications

Nutritional Considerations After Gastrectomy and Esophagectomy for Malignancy

Nutritional Considerations After Gastrectomy and Esophagectomy for Malignancy

Multidisciplinary therapeutic approach for maintaining long-term nutritional status for patient with advanced esophageal carcinoma confounded by dermatomyositis

The Effects of Early Post-Operative Soluble Dietary Fiber Enteral Nutrition for Colon Cancer

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