PMID- 34222299
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210706
IS  - 2296-861X (Print)
IS  - 2296-861X (Electronic)
IS  - 2296-861X (Linking)
VI  - 8
DP  - 2021
TI  - Therapeutic Effect and Cost-Benefit Analysis of Three Different Nutritional 
      Schemes for Esophageal Cancer Patients in the Early Post-operative Period.
PG  - 651596
LID - 10.3389/fnut.2021.651596 [doi]
LID - 651596
AB  - Objective: To retrospectively investigate the comparative efficacy, safety and 
      cost-benefits of three nutritional treatment schemes including short peptide 
      jejunal nutrition (SPJN), whole protein jejunal nutrition (WPJN), and partial 
      parenteral nutrition (PPN) in patients underwent esophagectomy for esophageal 
      cancer in our hospital. This study was carried out in accordance with the 
      conceptual framework of nutritional therapy in fast-track rehabilitation surgery. 
      Methods: We retrospectively reviewed 305 patients who were assigned to receive 
      esophagectomy for esophageal cancer. Eligible patients was naturally divided into 
      SPJN group [n = 98 (32.1%)], WPJN group [n = 95 (31.1%)], and PPN group [n = 112 
      (36.7%)] according to the type of nutritional scheme which was actually 
      prescribed to patients by the attendingphysician in clinical practice. The 
      differences of the serum total protein (TP), albumin (ALB), pre-albumin (PA), 
      hemoglobin (HGB), white blood cells (WBCs), red blood cells (RBCs) and 
      neutrophils were compared among 3 nutritional schemes groups. We also 
      investigated the relationship of the fluid intake, urine output, gastric juice 
      drainage volume and thoracic drainage volume among 3 nutritional groups at 3 days 
      after surgery. Moreover, the differences of cost-benefit indexes, complications, 
      length of hospitalization and hospital expenditure were also compared. Results: 
      The serum TP, ALB, and PA in the SPJN group were all higher than those in the 
      WPJN and PPN groups (p < 0.05). The gastric juice volume of gastrointestinal 
      decompression drainage and fluid volume of thoracic drainage in the SPJN group 
      were all less than that in the WPJN group (p < 0.05). The overall hospital stay 
      and post-operative hospital stay in the SPJN group were all shorter than that in 
      WPJN group (p < 0.05). Moreover, the incidence of post-operative complications 
      including anastomotic leakage, infection, and gastrointestinal reaction was 
      remarkably lower in the SPJN group compared to the WPJN group (p < 0.05). 
      Interesting, hospital expenditure in the PPN group was less than that in the SPJN 
      and the WPJN groups (p < 0.001). Conclusion: Patients may obtain benefits in 
      improving protein level after receiving SPJN scheme at the early stage after 
      esophagectomy. Meanwhile, patients may obtain benefits in improving 
      post-operative complications and hospital stay after receiving SPJN or PPN 
      compared to WPJN protocol. However, the difference between SPJN and PPN requires 
      further study because no difference was detected in terms of clinical outcomes 
      including complications and the length of hospitalization although PPN may 
      achieve a possible decrease of medical expenditure.
CI  - Copyright (c) 2021 Huang, Liang, Du, He, Bai, Feng, Liu, Tian and Wang.
FAU - Huang, Chen
AU  - Huang C
AD  - Department of Nutrition, Xinqiao Hospital of Army Medical University, Chongqing, 
      China.
FAU - Liang, Xinyu
AU  - Liang X
AD  - Department of Nutrition, Xinqiao Hospital of Army Medical University, Chongqing, 
      China.
FAU - Du, Shanshan
AU  - Du S
AD  - Department of Nutrition, Xinqiao Hospital of Army Medical University, Chongqing, 
      China.
FAU - He, Jie
AU  - He J
AD  - Department of Orthopedics, The Second Affiliated Hospital of Chongqing Medical 
      University, Chongqing, China.
FAU - Bai, Qian
AU  - Bai Q
AD  - Department of Nutrition, Xinqiao Hospital of Army Medical University, Chongqing, 
      China.
FAU - Feng, Xiaoqing
AU  - Feng X
AD  - Department of Nutrition, Xinqiao Hospital of Army Medical University, Chongqing, 
      China.
FAU - Liu, Xiaoqing
AU  - Liu X
AD  - Department of Thoracic Surgery, Xinqiao Hospital of Army Medical University, 
      Chongqing, China.
FAU - Tian, Xu
AU  - Tian X
AD  - Nursing Department, Universitat Rovira i Virgili, Tarragona, Spain.
AD  - Department of Gastroenterology, Chongqing University Cancer Hospital, Chongqing, 
      China.
FAU - Wang, Jian
AU  - Wang J
AD  - Department of Nutrition, Xinqiao Hospital of Army Medical University, Chongqing, 
      China.
LA  - eng
PT  - Journal Article
DEP - 20210617
PL  - Switzerland
TA  - Front Nutr
JT  - Frontiers in nutrition
JID - 101642264
PMC - PMC8247476
OTO - NOTNLM
OT  - cost-benefit
OT  - esophageal cancer
OT  - hospital stay
OT  - jejunal nutrition
OT  - liquid equilibrium
OT  - short peptide jejunal nutrition
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/07/06 06:00
MHDA- 2021/07/06 06:01
PMCR- 2021/01/01
CRDT- 2021/07/05 10:14
PHST- 2021/01/10 00:00 [received]
PHST- 2021/05/18 00:00 [accepted]
PHST- 2021/07/05 10:14 [entrez]
PHST- 2021/07/06 06:00 [pubmed]
PHST- 2021/07/06 06:01 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fnut.2021.651596 [doi]
PST - epublish
SO  - Front Nutr. 2021 Jun 17;8:651596. doi: 10.3389/fnut.2021.651596. eCollection 
      2021.