title: Pre-operative parenteral nutrition in patients with oesophageal cancer: a prospective, randomised clinical trial.
abstract: A prospective randomised clinical trial was conducted to examine the efficacy of 2 weeks pre-operative parenteral nutrition (PPN) for the prevention of complications following surgery for oesophageal cancer. Forty patients were studied, the diet of twenty being supplemented by pre-operative parenteral nutrition. There were no significant differences in age, nutritional status, tumour staging and histology between the two groups of patients. The use of PPN resulted in a significant gain in body weight and nitrogen but failed to produce an overall reduction in post-operative morbidity and mortality rates. However patients receiving PPN exhibited two types of changes in serum albumin levels. Those with a fall in serum albumin levels associated with an increase in body weight (indicating an expansion of extracellular volume) had a significantly higher incidence of post-operative pulmonary complications than the group exhibiting a rise in serum albumin levels concomitant with increase in body weight. These data suggested that two weeks PPN might not be adequate in certain patients and a longer period of PPN is required. They also show no clinical benefit from the routine use of pre-operative parenteral nutrition in all patients, but do not exclude benefit in selected groups.
authors.affiliation: Department of Surgery University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong, ROC.
authors.forename: S T
authors.initials: ST
authors.lastname: Fan
authors.forename: W Y
authors.initials: WY
authors.lastname: Lau
authors.forename: K K
authors.initials: KK
authors.lastname: Wong
authors.forename: Y P
authors.initials: YP
authors.lastname: Chan