J Clin Nutr.  2015 Dec;7(3):87-92. 10.15747/jcn.2015.7.3.87.

Evaluation of Postoperative Nutrition Support with Commercial Peripheral Parenteral Nutrition after an Ivor-Lewis Esophagectomy in Patients with Esophageal Cancer

• Lee SW
• Lim NR
• Park HJ
• In YW
• Seo JM
• Lee YM

• KMID: 2135218
• DOI: http://doi.org/10.15747/jcn.2015.7.3.87

Abstract

PURPOSE
Deteriorated nutritional status is common during a hospital stay for esophagectomy in patients with esophageal cancer. Malnutrition in those patients is often marked compared with other gastrointestinal cancer. The purpose of this study is to evaluate the appropriateness of commercial peripheral parenteral nutrition (CPPN) use in patients who underwent Ivor-Lewis esophagectomy (I-L op).
METHODS
Patients who were provided with CPPN after I-L op were enrolled in this study from January to May 2015. Body weight, height, nutritional status, length of hospital stay, duration of CPPN therapy, and parenteral nutrition (PN) induced complications were assessed, respectively, using electronic medical records.
RESULTS
Thirty-nine patients were enrolled. Average age was 65.9 years and 36 patients were male. All patients were provided with the same CPPN. The duration of fasting and CPPN use was 5.8+/-1.4 days and 7.5+/-1.8 days, respectively. Calorie supported by CPPN was 22.6+/-3.5 kcal/kg/day and only 20.5% of patients (n=8) reached the daily target calories. Most frequent PN induced complication was phlebitis which occurred in 8 patients (20.5%). Calcium, magnesium, and transthyretin levels in serum were not monitored during the PN support period.
CONCLUSION
The indications for CPPN were appropriate because the fasting duration in patients with I-L op was 5 to 10 days. Although a large portion of patients could not be supplied daily target calories, their nutrition status was not significantly changed on admission and at discharge. We did not find it necessary to individualize PN support for a short period after an I-L op in patients with esophageal cancer. Further study will be needed to determine why the incidence of phlebitis was dominant.

Keyword

Esophageal neoplasm; Postoperative,; Parenteral nutrition

MeSH Terms

Body Weight
Calcium
Electronic Health Records
Esophageal Neoplasms*
Esophagectomy*
Fasting
Gastrointestinal Neoplasms
Humans
Incidence
Length of Stay
Magnesium
Male
Malnutrition
Nutritional Status
Parenteral Nutrition*
Phlebitis
Prealbumin
Calcium
Magnesium
Prealbumin