Post-oesophagectomy early enteral nutrition via a needle catheter jejunostomy: 8-year experience at a specialist unit

Ryan, Aoife M.; Rowley, S.; Healy, Laura; Flood, P.; Ravi, Narayanasamy; Reynolds, John V.

doi:10.1016/j.clnu.2005.12.003

Cited by 115 publications

(99 citation statements)

References 31 publications

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“…In those studies that have used extended enteral feeding, it has been used selectively, with a reported prevalence ranging from 14% to 48% of patients [7,20,24,27,[37][38][39][40]. The wide variation in the practice of home jejunostomy likely reflects the preferences of individual centres.…”

Section: Discussionmentioning

confidence: 99%

“…Three studies considered dietary intake at different time points after esophagectomy [7,25,27] (Table 3). All estimated adequacy of intake in comparison to daily requirements, but only Haverkort et al [25] provided details of how energy and protein requirements were calculated.…”

Section: Changes In Dietary Intakementioning

confidence: 99%

“…Suboptimal intake of multiple vitamins and trace elements were identified with the following frequencies, folic acid (85%), vitamin D (61%), copper (56%), calcium (49%) and vitamin B1 (48%). In 205 patients, Ryan et al [7] observed that at discharge from hospital, oral intake of energy and nitrogen (protein) were 70% and 65% of the nutritional requirement respectively. No studies assessed the relationship between inadequacy of nutritional intake and change in nutritional status post-operatively.…”

Section: Changes In Dietary Intakementioning

confidence: 99%

“…In the largest of the studies, Ryan et al [7] reported on 205 patients and found that 26% of patients spent more than 14 days on enteral feeding. Eight percent of patients were discharged home on enteral feeding and a further 6% recommenced enteral feeding in the Europe PMC Funders Author Manuscripts first month after discharge because of unacceptable weight loss.…”

Section: Nutritional Support (Post Discharge After the Index Admissiomentioning

confidence: 99%

“…Nutritional considerations in these patients represent one of the greatest contributors to quality of life [7]. There are manifold reasons for aberrant nutrition after esophagectomy, including altered anatomy, early satiety, loss of appetite, taste and smell, and the postsurgery dumping syndrome [8].…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of the nutritional consequences of esophagectomy

et al. 2016

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SummaryBackground & aims-As improved outcomes after esophagectomy have been observed over the last two decades, the focus on care has shifted to survivorship and quality of life. The aim of this review was to determine changes in nutrition after esophagectomy and to assess the evidence for extended nutrition support.Methods-A search strategy was developed to identify primary research reporting change in nutritional status a minimum of one month after esophagectomy.Results-Changes in nutritional parameters reported by 18 studies indicated a weight loss of 5-12% at six months postoperatively. More than half of patients lost >10% of body weight at 12 months. One study reported a persistent weight loss of 14% from baseline three years after surgery. Three studies reporting on longer term follow up noted that 27%-95% of patients failed to regain their baseline weight. Changes in dietary intake (three studies) indicated inadequate energy and protein intake up to three years after surgery. Global quality of life scores reported in one study correlated with better weight preservation. There were a high frequency of gastrointestinal symptoms reported in six studies, most notably in the first year after surgery, but persisting up to 19 years. Extended enteral nutrition on a selective basis has been reported in several studies.Conclusions-Nutritional status is compromised in the months/years following oesophagectomy and may never return to baseline levels. The causes/consequences of weight loss/ impaired nutritional intake require further investigation. The role of extended nutritional support in this population remains unclear.

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Section: Discussionmentioning

confidence: 99%

Section: Changes In Dietary Intakementioning

confidence: 99%

Section: Changes In Dietary Intakementioning

confidence: 99%

Section: Nutritional Support (Post Discharge After the Index Admissiomentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A systematic review of the nutritional consequences of esophagectomy

et al. 2016

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Nutrition in Upper Gastrointestinal Cancer

Chowdhury¹,

Hynes²

2010

Nutrition and Cancer

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Effect of neoadjuvant chemoradiation on preoperative pulmonary physiology, postoperative respiratory complications and quality of life in patients with oesophageal cancer

Elliott

O’Byrne

Foley

et al. 2019

British Journal of Surgery

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Background It remains controversial whether neoadjuvant chemoradiation (nCRT) for oesophageal cancer influences operative morbidity, in particular pulmonary, and quality of life. This study combined clinical outcome data with systematic evaluation of pulmonary physiology to determine the impact of nCRT on pulmonary physiology and clinical outcomes in locally advanced oesophageal cancer. Methods Consecutive patients treated between 2010 and 2016 were included. Three‐dimensional conformal radiation was standard, with a lung dose–volume histogram of V20 less than 25 per cent, and total radiation between 40 and 41·4 Gy. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLCO) were assessed at baseline and 1 month after nCRT. Radiation‐induced lung injury (grade 2 or greater), comprehensive complications index (CCI) and pulmonary complications were monitored prospectively. Health‐related quality of life was assessed among disease‐free patients in survivorship. Results Some 228 patients were studied. Comparing pulmonary physiology values before with those after nCRT, FEV1 decreased from mean(s.d.) 96·8(17·7) to 91·5(20·4) per cent (–3·6(10·6) per cent; P < 0·001), FVC from 104·9(15·6) to 98·1(19·8) per cent (–3·2(11·9) per cent; P = 0·005) and DLCO from 97·6(20·7) to 82·2(20·4) per cent (–14·8(14·0) per cent; P < 0·001). Five patients (2·2 per cent) developed radiation‐induced lung injury precluding surgical resection. Smoking (P = 0·005) and increased age (P < 0·001) independently predicted percentage change in DLCO. Carboplatin and paclitaxel with 41·4 Gy resulted in a greater DLCO decline than cisplatin and 5‐fluorouracil with 40 Gy (P = 0·001). On multivariable analysis, post‐treatment DLCO predicted CCI (P = 0·006), respiratory failure (P = 0·020) and reduced physical function in survivorship (P = 0·047). Conclusion These data indicate that modern nCRT alters pulmonary physiology, in particular diffusion capacity, which is linked to short‐ and longer‐term clinical consequences, highlighting a potentially modifiable index of risk.

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Post-oesophagectomy early enteral nutrition via a needle catheter jejunostomy: 8-year experience at a specialist unit

Cited by 115 publications

References 31 publications

A systematic review of the nutritional consequences of esophagectomy

A systematic review of the nutritional consequences of esophagectomy

Nutrition in Upper Gastrointestinal Cancer

Effect of neoadjuvant chemoradiation on preoperative pulmonary physiology, postoperative respiratory complications and quality of life in patients with oesophageal cancer

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