Supportive nutrition on recovery of metabolism, nutritional state, health-related quality of life, and exercise capacity after major surgery: a randomized study

Clin Gastroenterol Hepatol. 2005 May;3(5):466-74. doi: 10.1016/s1542-3565(05)00151-5.

Abstract

Background & aims: The aim of this study was to investigate whether specialized supportive enteral and parenteral feeding have superior effects compared to oral nutrition on recovery during long-term postoperative treatment of cancer patients with preoperative weight loss and reduced maximum exercise capacity.

Methods: One hundred twenty-six patients referred for resection of the esophagus (n = 48), stomach (n = 28), or pancreas (n = 50) were considered to be included before operation. Included patients (n = 80) received supportive enteral or parenteral nutrition postoperatively at home corresponding to 1000 kcal/d until the patients did not wish to continue with artificial nutrition for any reason. Patients randomized to oral nutrition only served as control subjects. Caloric intake, body composition (dual-energy x-ray absorptiometry), and respiratory gas exchanges at rest and during exercise were measured including health-related quality of life.

Results: Survival and hospital stay did not differ among the groups, whereas overall complications were higher on artificial nutrition (P < .05). Changes in resting energy expenditure and biochemical tests did not differ during follow-up among the groups. Body weight and whole body fat declined similarly over time in all groups (P < .005), whereas lean body mass was unchanged during follow-up compared to preoperative values. Maximum exercise capacity and maximum oxygen consumption were normalized within 6 months postoperatively in all groups. There was no difference in recovery of food intake among the groups. Parenteral feeding was associated with the highest rate of nutrition-related complications, whereas enteral feeding reduced quality of life most extensively.

Conclusion: After major surgery, specialized supportive enteral and parenteral nutrition are not superior to oral nutrition only when guided by a dietitian.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Composition
  • Dietary Proteins / administration & dosage
  • Energy Intake
  • Energy Metabolism
  • Esophagus / surgery*
  • Exercise Tolerance
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasms / surgery
  • Nutritional Support / adverse effects
  • Nutritional Support / methods*
  • Oxygen Consumption
  • Pancreas / surgery*
  • Postoperative Care*
  • Pulmonary Gas Exchange
  • Quality of Life
  • Recovery of Function
  • Stomach / surgery*
  • Treatment Outcome

Substances

  • Dietary Proteins