Pancreatic enzyme supplementation after gastrectomy for gastric cancer: a randomized controlled trial.

Autor: Catarci M; General and Oncologic Surgery, Department of Oncology, San Filippo Neri Hospital, Rome, Italy. marcocatarci@gmail.com.; Direttore UOC Chirurgia Generale, Ospedale 'C. e G. Mazzoni', AV5-ASUR Marche, Via degli Iris, 63100, Ascoli Piceno, Italy. marcocatarci@gmail.com., Berlanda M; General and Oncologic Surgery, Department of Oncology, San Filippo Neri Hospital, Rome, Italy., Grassi GB; General and Oncologic Surgery, Department of Oncology, San Filippo Neri Hospital, Rome, Italy., Masedu F; Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy., Guadagni S; Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.
Jazyk: angličtina
Zdroj: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association [Gastric Cancer] 2018 May; Vol. 21 (3), pp. 542-551. Date of Electronic Publication: 2017 Aug 14.
DOI: 10.1007/s10120-017-0757-y
Abstrakt: Background: Gastrectomy for gastric cancer is a significant cause of secondary exocrine pancreatic insufficiency. Pancreatic enzyme replacement therapy may influence nutritional status and quality of life after gastrectomy, but the pertinent clinical research to date remains controversial. A randomized controlled trial to test this hypothesis was carried out.
Methods: After gastrectomy, 43 patients with gastric cancer were randomly assigned to a normal diet (Normal-d; n = 21) or to a pancreatic enzyme supplementation diet (PES-d; n = 22) and were followed up during a 12-month period, assessing nutritional status and quality of life through body mass index (BMI), instant nutritional assessment (INA) class status, serum pre-albumin (SPA) values, and GastroiIntestinal Quality of Life Index (GIQLI).
Results: BMI was not significantly influenced by the type of diet; INA class status was significantly improved in the PES-d arm, particularly during the first 3 months after gastrectomy; SPA levels increased in both arms at 6 months after gastrectomy, reaching significantly higher values in the PES-d arm at 12 months. GIQLI was not significantly influenced by the type of diet throughout the follow-up period; however, this index significantly improved in the PES-d arm between the first and third month after gastrectomy.
Conclusions: PES-d improves nutritional status and quality of life after gastrectomy for gastric cancer, particularly within 3 months from the operation. A larger, multicenter trial is necessary to address the potential influence of several confounding variables such as disease stage and adjuvant treatments.
Databáze: MEDLINE
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