Artificial nutritional support in cancer patients after esophagectomy: 11 years of experience

Autor:	Elisabet Leiva-Badosa, Leandre Farran-Teixidor, Maria-Carmen Galán-Guzmán, J. Llop-Talaveron, Maria Virgili-Casas, Humberto Aranda-Danso, Maria B. Badia-Tahull, Mónica Miró-Martín
Rok vydání:	2014
Předmět:	Male Cancer Research medicine.medical_specialty Parenteral Nutrition Esophageal Neoplasms medicine.medical_treatment Medicine (miscellaneous) Enteral Nutrition Risk Factors Internal medicine Medicine Humans Medical nutrition therapy Aged Proportional Hazards Models Retrospective Studies Nutrition and Dietetics business.industry Proportional hazards model Respiratory infection Retrospective cohort study Esophageal cancer Middle Aged medicine.disease Confidence interval Surgery Esophagectomy Parenteral nutrition Logistic Models Treatment Outcome Oncology Multivariate Analysis Female business
Zdroj:	Nutrition and cancer. 66(6)
ISSN:	1532-7914
Popis:	Esophageal cancer represents a high-risk group of patients. This study determines the association of artificial nutrition with morbidity, mortality, and survival and studies clinical situations that determine the choice between enteral (EN) and parenteral support (PN). This retrospective single-center study compared 2 periods: 1) treatment centered in surgical process with discretionary demand of support, and 2) elective therapeutic and nutritional interventions were systematized. Risks factors that determined use of PN and survival were included in 4 multivariate regression models: 2 logistic, 1 multinomial, and a survival Cox analysis. Significance determined with 95% confidence interval (CI) of 95%; inclusion criteria was P0.1. During an 11-yr period, 175 patients were studied. Artificial nutrition consisted of 45 jejunostomy EN, 28 PN, and 102 both. Risk factors that conditioned PN were first period (OR: 2.41; 95% CI: 1.13-5.14), stay in intensive care unit (ICU)3 days (OR: 1.70; 95% CI: 0.93-3.71), and surgical reintervention (OR: 3.83; 95% CI: 0.94-16.95). Risk factors associated with mortality were first period (OR: 22.7; 95% CI: 2.31-172.05), respiratory infection (OR: 11.23; 95% CI: 2.33-55.5) and coloplasty surgery (OR: 13.16; 95% CI: 2.11-83.33). Longer survival was associated with second period (OR: 2.36; 95% CI: 1.38-4.05) and lower neoplasm staging (OR: 1.43; 95% CI: 1.21-1.69). A multidisciplinary management that includes nutritional support of esophagectomized patients is 1 of the factors that improves survival. Protocol implies greater use of EN; PN remains an important nutritional therapy.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::283a93199cd8dec598d527f8dadd7288 https://pubmed.ncbi.nlm.nih.gov/25102052 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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