Serial changes in contribution of substrates to energy expenditure after transthoracic esophagectomy for cancer

Sato, Nobuaki; Oyamatsu, Manabu; Tsukada, Kazuhiro; Suzuki, Tsutomu; Hatakeyama, Katsuyoshi; Muto, Terukazu

doi:10.1016/s0899-9007(96)00382-6

Cited by 22 publications

(9 citation statements)

References 12 publications

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“…Patients with a high FFM experience a higher energy requirement during the postoperative chronic recovery term, during which the REE is the main energy expenditure. However, patients are reported to experience hypermetabolism caused by multiple factors in the acute stage after esophagectomy . Our results also showed no association between FFM and short‐term SWL.…”

Section: Discussioncontrasting

confidence: 48%

“…However, patients are reported to experience hypermetabolism caused by multiple factors in the acute stage after esophagectomy. 39,40 Our results also showed no association between FFM and short-term SWL. Patients with an ASA score of 3-4 always suffer from severe systemic diseases and dysfunction before surgery, which appear to affect not only perioperative complications and mortality but also postoperative weight recovery.…”

Section: Discussioncontrasting

confidence: 38%

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Analysis of the associated factors for severe weight loss after minimally invasive McKeown esophagectomy

Wang

Sun

et al. 2018

Thoracic Cancer

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BackgroundThis study investigated the risk factors for severe weight loss (SWL) within one year after minimally invasive McKeown esophagectomy.MethodsEsophageal cancer patients who underwent McKeown esophagectomy between January and July 2017 were prospectively enrolled. Preoperative body weight (PBW) was chosen as the initial body weight.ResultsForty‐four patients were enrolled and successfully followed up for one year. Median weight loss was 7.4% (quartile: 5.3–8.1%) and 12.6% (quartile: 8.8–17.7%) four weeks and one year after surgery, respectively. Accelerated weight loss occurred during the first two weeks after discharge, with median weight loss of 5.6% (quartile: 4.2–7.1%). Multivariable analysis showed that age ≥ 70 years (odds ratio [OR] 7.65; P = 0.030), preoperative sarcopenia (OR 7.18; P = 0.030), the first surgery in the daily schedule (OR 6.87; P = 0.032) and vocal cord paralysis (OR 12.30; P = 0.046) were independent risk factors for short‐term (4 weeks) SWL (> 7.5% PBW), while an American Society of Anesthesiologists score of 3–4 (OR 6.58; P = 0.047), a high fat‐free mass (OR 21.91; P = 0.003), and vocal cord paralysis (OR 25.83; P = 0.017) were independent risk factors for long‐term (1 year) SWL (> 13.0% PBW) after esophagectomy. Postoperative symptoms of insomnia, appetite loss, dysphagia, eating difficulties, and taste issues were also related to SWL.ConclusionsIn esophageal cancer patients who have undergone esophagectomy, the first two weeks after hospital discharge is a key period for nutrition intervention. Patients with associated factors for SWL require postoperative nutrition support.

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Section: Discussioncontrasting

confidence: 48%

Section: Discussioncontrasting

confidence: 38%

Analysis of the associated factors for severe weight loss after minimally invasive McKeown esophagectomy

Wang

Sun

et al. 2018

Thoracic Cancer

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“…Sato et al (18,19) showed a 31% increase in the mREE in patients undergoing an esophagectomy. However, the increased rate in the mREE in our patients was lower than that from previous studies.…”

Section: Discussionmentioning

confidence: 98%

Resting energy expenditure and nutritional status in patients undergoing transthoracic esophagectomy for esophageal cancer

Okamoto

Sasaki

Johtatsu

et al. 2011

J. Clin. Biochem. Nutr.

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This study was to assess the resting energy expenditure of patients with esophageal cancer using indirect calorimetry. Eight male patients with esophageal cancer and eight male healthy controls were enrolled in this study. All patients underwent transthoracic esophagectomy with lymph nodes dissections. The resting energy expenditure was measured preoperatively, and on postoperative day 7 and 14 using indirect calorimetry. Preoperatively, the measured resting energy expenditure/body weight in these patients was significantly higher than that of the controls (23.3 ± 2.1 kcal/kg/day vs 20.4 ± 1.6 kcal/kg/day), whereas the measured/predicted energy expenditure from the Harris-Benedict equation ratio was 1.01 ± 0.09, which did not differ significantly from the control values. The measured resting energy expenditure/body weight was 27.3 ± 3.5 kcal/kg/day on postoperative day 7, and 23.7 ± 5.07 kcal/kg/day on postoperative day 14. Significant increases in the measured resting energy expenditure were observed on postoperative day 7, and the measured/predicted energy expenditure ratio was 1.17 ± 0.15. In conclusion, patients with operable esophageal cancers were almost normometabolic before surgery. On the other hand, the patients showed a hyper-metabolic status after esophagectomy. We recommended that nutritional management based on 33 kcal/body weight/day (calculated by the measured resting energy expenditure × active factor 1.2–1.3) may be optimal for patients undergoing esophagectomy.

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“…have reported that resting energy expenditure is significantly increased following esophagectomy and that this response was attenuated in patients who underwent less invasive, transhiatal resection . While carbohydrate oxidation increased significantly after esophagectomy, the caloric contribution of fat decreased . Tashiro et al .…”

Section: Mechanisms Of Lung Injury During Esophagectomymentioning

confidence: 99%

Pathophysiology of acute lung injury following esophagectomy

2014

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KEY WORDS: acute lung injury, acute respiratory distress syndrome, esophagectomy, pathophysiology, postoperative complications.Esophagectomy is widely considered to be a high risk surgical approach. While improvements in surgical technique, perioperative monitoring, and postoperative care have led to a reduction in mortality following esophagectomy, early mortality remains between 5% and 10%. 1,2 Moreover, postoperative complications, involving predominantly the cardiorespiratory system, occur in up to 50% of patients. 3 Of the numerous respiratory complications that are associated with esophagectomy, acute lung injury (ALI) and its more severe form acute respiratory distress syndrome (ARDS) are of notable significance due to their prevalence and impact on early morbidity and mortality. 4 Reported rates of ALI and ARDS following esophagectomy are 23.8% and 14.5% respectively, the latter associated with 50% mortality. 4 While the existence of an accepted clinical definition for ALI/ARDS 5 has greatly contributed to the wider study of ALI/ARDS, continued variability in reporting practices has meant that the pathophysiology of this syndrome in the context of esophagectomy remains incompletely understood. Notwithstanding, patient-specific factors, the extent and nature of surgical trauma, and frequent requirement for periods of one-lung ventilation (OLV) are all anticipated to contribute to the development of ALI/ARDS following esophagectomy through their influence on systemic and local inflammatory responses. Consequently, the aim of this review is to define the pathophysiology of ALI/ARDS in the setting of esophagectomy and to explore potential strategies for prediction and prevention of this complication. PATHOPHYSIOLOGY OF ALI/ARDSAs first described by Ashbaugh et al. in 1967, ALI/ ARDS is recognized as a constellation of clinical, radiological, and physical abnormalities that collectively define an underlying picture of diffuse damage to the alveolar capillary unit and associated pulmonary gas exchange disturbance. 6 Central to this process is disruption of vascular endothelial and pulmonary epithelial linings and subsequent flooding of the alveolar and interstitial spaces with proteinaceous fluid, rich in inflammatory mediations and leukocytes. 7 Causes of ALI/ARDS can be broadly divided between those that result in either direct or indirect lung injury. Common sources of direct lung injury include: pneumonia, aspiration, trauma, reperfusion, and inhalation injury. Alternatively, sepsis, shock, polytrauma, and blood transfusion are common sources of indirect lung injury. 8 In patients undergoing esophagectomy precipitants of ALI/ARDS may reflect both local and systemic insults.

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Serial changes in contribution of substrates to energy expenditure after transthoracic esophagectomy for cancer

Cited by 22 publications

References 12 publications

Analysis of the associated factors for severe weight loss after minimally invasive McKeown esophagectomy

Analysis of the associated factors for severe weight loss after minimally invasive McKeown esophagectomy

Resting energy expenditure and nutritional status in patients undergoing transthoracic esophagectomy for esophageal cancer

Pathophysiology of acute lung injury following esophagectomy

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