Effectiveness of postoperative elemental diet (Elental®) in elderly patients after gastrectomy

Abstract

BackgroundWe aimed to investigate the efficacy of postoperative early intervention with an elemental diet to reduce weight loss and enhance recovery after gastrectomy. Nutritional status and gastrointestinal immune function tend to worsen, and postoperative weight loss is inevitable in these patients; therefore, improvement in their postoperative condition is important, especially in gastric cancer patients aged ≥80 years.MethodsClinical outcomes and postoperative nutritional status were compared between 21 and 22 consecutive elderly patients aged ≥80 years who underwent distal gastrectomy before and after the introduction of postoperative oral elemental diet (Elental®, 300 kcal/day), respectively, between October 2011 and June 2016.ResultsA significant reduction in postoperative complications was noted in the nutrition support group (N-group) as compared with the control group (C-group). In particular, the prevalence of systemic complications was significantly lower in the N-group (33.3 vs. 4.5 %, p = 0.015), whereas no significant difference was observed in the prevalence of locoregional complications. The percentage of weight loss and reduction in BMI from 1 month to 1 year after surgery was significantly lower in the N-group (p = 0.012 each). The nutrition status (albumin, total protein, hemoglobin, and C-reactive protein levels) at 1 month after surgery showed improvements (p = 0.005, p = 0.048), and hospital stay was decreased in the N-group as compared to the C-group (16.0 vs. 12.5 days, p = 0.041).ConclusionsEarly intervention with an elemental diet after distal gastrectomy is valuable for reducing perioperative weight loss and improving nutritional management and may be associated with enhanced postoperative recovery in elderly patients.

Body Composition Changes in Gastric Cancer Patients during Preoperative FLOT Therapy: Preliminary Results of an Italian Cohort Study

“…Furthermore, the association of low SMI at diagnosis with a poorer OS was assessed in more than 5600 GC patients [ 13 ]. After surgery, a majority of patients experience a significant weight loss during the first two months due to postoperative complications, poor nutrition, prolonged hospital stay, and deterioration of quality of life [ 39 , 40 ]. In this context, further prospective studies should evaluate whether preoperative changes in body composition can impact postoperative complications and quality of life.…”

Comparison of Weight and Body Composition After Gastrectomy Between Elderly and Non-elderly Patients With Gastric Cancer

“…Ohkura et al evaluated the efficacy of postoperative early intervention with an elemental diet to reduce body weight loss in elderly patients with gastric cancer (≥80 years of age). They showed that early intervention with an elemental diet after distal gastrectomy was useful for reducing perioperative weight loss in elderly patients (23). However, they did not evaluate the lean body mass loss.…”

Appraisal of long-time outcomes after curative surgery in elderly patients with gastric cancer: a propensity score matching analysis

“…Propensity score matching was used to balance the two groups, but the results must be interpreted carefully. Second, there are various definitions of the elderly patient [ 16 , 29 ]. Currently, the Japanese Geriatrics Society has proposed to redefine the elderly as 75 years of age or older, and thus we adopted a threshold of 75 years [ 30 ].…”