Therapeutic Effect and Cost-Benefit Analysis of Three Different Nutritional Schemes for Esophageal Cancer Patients in the Early Post-operative Period

作者全名："Huang, Chen; Liang, Xinyu; Du, Shanshan; He, Jie; Bai, Qian; Feng, Xiaoqing; Liu, Xiaoqing; Tian, Xu; Wang, Jian"

作者地址："[Huang, Chen; Liang, Xinyu; Du, Shanshan; Bai, Qian; Feng, Xiaoqing; Wang, Jian] Army Med Univ, Xinqiao Hosp, Dept Nutr, Chongqing, Peoples R China; [He, Jie] Chongqing Med Univ, Affiliated Hosp 2, Dept Orthoped, Chongqing, Peoples R China; [Liu, Xiaoqing] Army Med Univ, Xinqiao Hosp, Dept Thorac Surg, Chongqing, Peoples R China; [Tian, Xu] Univ Rovira & Virgili, Nursing Dept, Tarragona, Spain; [Tian, Xu] Chongqing Univ, Canc Hosp, Dept Gastroenterol, Chongqing, Peoples R China"

通信作者："Wang, J (corresponding author), Army Med Univ, Xinqiao Hosp, Dept Nutr, Chongqing, Peoples R China.; Tian, X (corresponding author), Univ Rovira & Virgili, Nursing Dept, Tarragona, Spain.; Tian, X (corresponding author), Chongqing Univ, Canc Hosp, Dept Gastroenterol, Chongqing, Peoples R China."

来源：FRONTIERS IN NUTRITION

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000668622300001

JCR分区：Q2

影响因子：5

年份：2021

卷号：8

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：esophageal cancer; jejunal nutrition; short peptide jejunal nutrition; liquid equilibrium; hospital stay; cost-benefit

摘要："Objective: To retrospectively investigate the comparative efficacy, safety and cost-benefits of three nutritional treatment schemes including short peptide jejunal nutrition (SPJN), whole protein jejunal nutrition (WPJN), and partial parenteral nutrition (PPN) in patients underwent esophagectomy for esophageal cancer in our hospital. This study was carried out in accordance with the conceptual framework of nutritional therapy in fast-track rehabilitation surgery. Methods: We retrospectively reviewed 305 patients who were assigned to receive esophagectomy for esophageal cancer. Eligible patients was naturally divided into SPJN group [n = 98 (32.1%)], WPJN group [n = 95 (31.1%)], and PPN group [n = 112 (36.7%)] according to the type of nutritional scheme which was actually prescribed to patients by the attendingphysician in clinical practice. The differences of the serum total protein (TP), albumin (ALB), pre-albumin (PA), hemoglobin (HGB), white blood cells (WBCs), red blood cells (RBCs) and neutrophils were compared among 3 nutritional schemes groups. We also investigated the relationship of the fluid intake, urine output, gastric juice drainage volume and thoracic drainage volume among 3 nutritional groups at 3 days after surgery. Moreover, the differences of cost-benefit indexes, complications, length of hospitalization and hospital expenditure were also compared. Results: The serum TP, ALB, and PA in the SPJN group were all higher than those in the WPJN and PPN groups (p < 0.05). The gastric juice volume of gastrointestinal decompression drainage and fluid volume of thoracic drainage in the SPJN group were all less than that in the WPJN group (p < 0.05). The overall hospital stay and post-operative hospital stay in the SPJN group were all shorter than that in WPJN group (p < 0.05). Moreover, the incidence of post-operative complications including anastomotic leakage, infection, and gastrointestinal reaction was remarkably lower in the SPJN group compared to the WPJN group (p < 0.05). Interesting, hospital expenditure in the PPN group was less than that in the SPJN and the WPJN groups (p < 0.001). Conclusion: Patients may obtain benefits in improving protein level after receiving SPJN scheme at the early stage after esophagectomy. Meanwhile, patients may obtain benefits in improving post-operative complications and hospital stay after receiving SPJN or PPN compared to WPJN protocol. However, the difference between SPJN and PPN requires further study because no difference was detected in terms of clinical outcomes including complications and the length of hospitalization although PPN may achieve a possible decrease of medical expenditure."

基金机构：project: research and application of key technologies for remote diabetes nutrition and weight management based on Internet Plus [ctstc2015shmszx120014]; study on raising technique and meat nutrition level of Tibetan fragrant pig in Chongqing [cstc2019jsyj-yzysbAX0023]

基金资助正文：This research was supported by project: research and application of key technologies for remote diabetes nutrition and weight management based on Internet Plus (ctstc2015shmszx120014) and study on raising technique and meat nutrition level of Tibetan fragrant pig in Chongqing (cstc2019jsyj-yzysbAX0023).