ObjectiveTo compare the effects of oral intake and nasogastric tube(NG)feeding on nutritional status,complications and survival during neoadjuvant chemoradiotherapy for esophageal squamous-cell carcinoma(ESCC)patients...ObjectiveTo compare the effects of oral intake and nasogastric tube(NG)feeding on nutritional status,complications and survival during neoadjuvant chemoradiotherapy for esophageal squamous-cell carcinoma(ESCC)patients.MethodsA total of 61 ESCC cases treated with neoadjuvant chemoradiotherapy from December 2018 to March 2020 were enrolled,including(38 in oral intake group,and 22 in NG feeding group.Disease characteristics and baseline nutritional markers were collected in both groups.Nutritional status,complication and completion rate of chemoradiotherapy in both groups were evaluated.ResultsCompared with the oral intake group,patients in the NG feeding group had a later T stage(P=0.027)and clinical stage(P=0.014).The levels of energy intake(P=0.033),serum prealbumin(P<0.001),albumin(P=0.017)and hemoglobin(P=0.015)before treatment in NG group were significantly lower than those in oral intake group.Furthermore,patient-generated subjective global assessment(PG-SGA)score(P=0.016)and the levels of serum C-reactive protein(P=0.014)of NG feeding group were significantly higher than those of oral intake group.However,at the end of treatment,PG-SGA scores were increased in oral intake group and decreased in NG feeding group.In addition,the NG feeding group had a lower incidence of grade≥2 esophagitis(P=0.037),and higher completion rate of chemotherapy compared with oral intake group(P=0.034).Meanwhile,the proportion of parenteral nutrition(P=0.008)and anti-inflammatory(P=0.022)treatment in NG feeding group was significantly lower than that in oral intake group.Although patients in the NG feeding group had a worse prognosis,there were no statistically significant differences in overall survival(OS)and progression-free survival(PFS)between the two groups(P>0.05).ConclusionsAs a safe and effective enteral nutrition approach to improving nutrition,nasogastric tube feeding could increase treatment completion rate and reduce the incidence of≥grade 2 esophagitis reaction during neoadjuvant chemoradiotherapy.展开更多
Objectives: Aim of our work is to study the effect of early enteral feeding through either nasoentral or feeding jejunostomy tube post esophagectomy on patients recovery and hospital stay. Background: Postoperative nu...Objectives: Aim of our work is to study the effect of early enteral feeding through either nasoentral or feeding jejunostomy tube post esophagectomy on patients recovery and hospital stay. Background: Postoperative nutrition is a well known aspect of care in recent years and has been shown to decrease the incidence of complications and hospital stay. Enteral nutrition has been shown to be superior to parenteral nutrition as it is more physiological, safer, cheaper and early enteral nutrition has been clearly confirmed to reduce postoperative morbidity. Methods: This is randomized combined retrospective and prospective study that is conducted in surgical oncology department, South Egypt cancer institute, Assiut University;from October 2012 to October 2016. Patients in this study were divided into two groups: group 1 includes patients with feeding jejunostomy and group 2 is patients with nasoenteral tube. Results: 25 Patients included in this study (19 males & 6 females). All cases were primarily diagnosed as esophageal cancer, middle and lower 1/3 esophagus or proximal gastric carcinoma infiltrating cardia by clinical data associated with abdominal sonar and/or C.T scan and upper endoscopy with biopsy. There was no significant difference in catheter related complications (P value 0.238). There was no operative mortality. Conclusion: Early postoperative enteral nutrition was feasible and safe for patients undergoing esophagectomy. There is no significant difference between NE and FJ. Enteral nutrition either through nasoenteral or feeding jejunostomy is an effective method for postoperative nutritional support in this type of major surgery.展开更多
Some controversy surrounds the postoperative feeding regimen utilized in patients who undergo esophagectomy.Variation in practices during the perioperative period exists including the type of nutrition started,the del...Some controversy surrounds the postoperative feeding regimen utilized in patients who undergo esophagectomy.Variation in practices during the perioperative period exists including the type of nutrition started,the delivery route,and its timing.Adequate nutrition is essential for this patient population as these patients often present with weight loss and have altered eating patterns after surgery,which can affect their ability to regain or maintain weight.Methods of feeding after an esophagectomy include total parenteral nutrition,nasoduodenal/nasojejunal tube feeding,jejunostomy tube feeding,and oral feeding.Recent evidence suggests that early oral feeding is associated with shorter LOS,faster return of bowel function,and improved quality of life.Enhanced recovery pathways after surgery pathways after esophagectomy with a component of early oral feeding also seem to be safe,feasible,and cost-effective,albeit with limited data.However,data on anastomotic leaks is mixed,and some studies suggest that the incidence of leaks may be higher with early oral feeding.This risk of anastomotic leak with early feeding may be heavily modulated by surgical approach.No definitive data is currently available to definitively answer this question,and further studies should look at how these early feeding regimens vary by surgical technique.This review aims to discuss the existing literature on the optimal route and timing of feeding after esophagectomy.展开更多
文摘ObjectiveTo compare the effects of oral intake and nasogastric tube(NG)feeding on nutritional status,complications and survival during neoadjuvant chemoradiotherapy for esophageal squamous-cell carcinoma(ESCC)patients.MethodsA total of 61 ESCC cases treated with neoadjuvant chemoradiotherapy from December 2018 to March 2020 were enrolled,including(38 in oral intake group,and 22 in NG feeding group.Disease characteristics and baseline nutritional markers were collected in both groups.Nutritional status,complication and completion rate of chemoradiotherapy in both groups were evaluated.ResultsCompared with the oral intake group,patients in the NG feeding group had a later T stage(P=0.027)and clinical stage(P=0.014).The levels of energy intake(P=0.033),serum prealbumin(P<0.001),albumin(P=0.017)and hemoglobin(P=0.015)before treatment in NG group were significantly lower than those in oral intake group.Furthermore,patient-generated subjective global assessment(PG-SGA)score(P=0.016)and the levels of serum C-reactive protein(P=0.014)of NG feeding group were significantly higher than those of oral intake group.However,at the end of treatment,PG-SGA scores were increased in oral intake group and decreased in NG feeding group.In addition,the NG feeding group had a lower incidence of grade≥2 esophagitis(P=0.037),and higher completion rate of chemotherapy compared with oral intake group(P=0.034).Meanwhile,the proportion of parenteral nutrition(P=0.008)and anti-inflammatory(P=0.022)treatment in NG feeding group was significantly lower than that in oral intake group.Although patients in the NG feeding group had a worse prognosis,there were no statistically significant differences in overall survival(OS)and progression-free survival(PFS)between the two groups(P>0.05).ConclusionsAs a safe and effective enteral nutrition approach to improving nutrition,nasogastric tube feeding could increase treatment completion rate and reduce the incidence of≥grade 2 esophagitis reaction during neoadjuvant chemoradiotherapy.
文摘Objectives: Aim of our work is to study the effect of early enteral feeding through either nasoentral or feeding jejunostomy tube post esophagectomy on patients recovery and hospital stay. Background: Postoperative nutrition is a well known aspect of care in recent years and has been shown to decrease the incidence of complications and hospital stay. Enteral nutrition has been shown to be superior to parenteral nutrition as it is more physiological, safer, cheaper and early enteral nutrition has been clearly confirmed to reduce postoperative morbidity. Methods: This is randomized combined retrospective and prospective study that is conducted in surgical oncology department, South Egypt cancer institute, Assiut University;from October 2012 to October 2016. Patients in this study were divided into two groups: group 1 includes patients with feeding jejunostomy and group 2 is patients with nasoenteral tube. Results: 25 Patients included in this study (19 males & 6 females). All cases were primarily diagnosed as esophageal cancer, middle and lower 1/3 esophagus or proximal gastric carcinoma infiltrating cardia by clinical data associated with abdominal sonar and/or C.T scan and upper endoscopy with biopsy. There was no significant difference in catheter related complications (P value 0.238). There was no operative mortality. Conclusion: Early postoperative enteral nutrition was feasible and safe for patients undergoing esophagectomy. There is no significant difference between NE and FJ. Enteral nutrition either through nasoenteral or feeding jejunostomy is an effective method for postoperative nutritional support in this type of major surgery.
文摘Some controversy surrounds the postoperative feeding regimen utilized in patients who undergo esophagectomy.Variation in practices during the perioperative period exists including the type of nutrition started,the delivery route,and its timing.Adequate nutrition is essential for this patient population as these patients often present with weight loss and have altered eating patterns after surgery,which can affect their ability to regain or maintain weight.Methods of feeding after an esophagectomy include total parenteral nutrition,nasoduodenal/nasojejunal tube feeding,jejunostomy tube feeding,and oral feeding.Recent evidence suggests that early oral feeding is associated with shorter LOS,faster return of bowel function,and improved quality of life.Enhanced recovery pathways after surgery pathways after esophagectomy with a component of early oral feeding also seem to be safe,feasible,and cost-effective,albeit with limited data.However,data on anastomotic leaks is mixed,and some studies suggest that the incidence of leaks may be higher with early oral feeding.This risk of anastomotic leak with early feeding may be heavily modulated by surgical approach.No definitive data is currently available to definitively answer this question,and further studies should look at how these early feeding regimens vary by surgical technique.This review aims to discuss the existing literature on the optimal route and timing of feeding after esophagectomy.
