Feeding protocol deviation after esophagectomy: A retrospective multicenter study

被引：12

作者：

Berkelmans, Gijs H. K. ^{[1
]}

Kingma, B. Feike ^{[2
]}

Fransen, Laura F. C. ^{[1
]}

Nieuwenhuijzen, Grard A. P. ^{[1
]}

Ruurda, Jelle P. ^{[2
]}

van Hillegersberg, Richard ^{[2
]}

Luyer, Misha D. P. ^{[1
]}

机构：

[1] Catharina Hosp, Dept Surg, Michelangelolaan 2, NL-5623 EJ Eindhoven, Netherlands

[2] Univ Med Ctr, Dept Surg, Heidelberglaan 100, Utrecht, Netherlands

来源：

CLINICAL NUTRITION | 2020年 / 39卷 / 04期

关键词：

Esophagectomy; Feeding protocol deviation; Complications; PARENTERAL-NUTRITION; ENHANCED RECOVERY; OPEN-LABEL; SURGERY; CANCER; PATHWAY; LENGTH; FOOD;

D O I：

10.1016/j.clnu.2019.05.018

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 ;

摘要：

Background: Esophagectomy is associated with high postoperative morbidity rates, which can result in decreased quality of life and impaired recovery. Implementation of enhanced recovery after surgery (ERAS) protocols have made a great impact in optimizing postoperative recovery. However, the best timing to start oral intake is still unclear. Conservative feeding protocols have been developed with a nilby-mouth period in the first postoperative days to reduce postoperative complication rates (e.g. anastomotic leakage and pneumonia). This study aimed to evaluate adherence to the feeding protocol following minimal invasive esophagectomy and identify reasons for protocol deviation. Methods: All consecutive patients who underwent an esophagectomy with gastric tube reconstruction between 2014 and 2016 in two high-volume hospitals in the Netherlands were retrospectively analyzed. All patients were planned to receive enteral tube feeding via jejunostomy directly after surgery. Data regarding postoperative feeding related symptoms (e.g. nausea, vomiting, regurgitation) and adherence to the postoperative feeding protocol were gathered. Results: A total of 186 patients were included. Feeding protocol deviation was observed in 109 patients (59%) and was significantly more common in patients with anastomotic leakage, chyle leakage, and acute respiratory distress. Postoperative feeding related symptoms were present in 107 patients (58%) and were significantly more common in female patients and patients with a cervical anastomosis. Conclusion: In this study, more than half of the patients deviated from the intended feeding protocol after esophagectomy. Postoperative complications appeared to be the main reason for feeding protocol deviation. This study shows that a predefined feeding protocol including an oral fasting period is often violated because of complications. (C) 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

引用

页码：1258 / 1263

页数：6

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