title: Perioperative peripheral parenteral nutrition for patients undergoing esophagectomy for cancer: a pilot study of safety, surgical, and nutritional outcomes.
abstract: At esophagectomy, cancer patients may be malnourished. Nutrition administered central venously is associated with complications, potentially negating nutritional benefits. We aimed to determine the safety of nutrition administered by the peripheral parenteral route (PPN) and record changes in nutritional and surgical outcome. Ivor-Lewis esophagectomy was performed by a single experienced surgeon. Consecutive patients received either 7 days of PPN perioperatively (n = 16) or oral diet reintroduction on the fourth postoperative day (n = 11). Mortality, complications, measures of body composition, protein metabolism, and biochemistry were assessed. Thirty-day mortality was 0% and 18% in the PPN and standard group, respectively. By the 90th day, mortality had increased to 36% in the standard group (P < 0.05). Perioperative PPN can be administered safely in cancer patients undergoing esophagectomy. This form of nutritional support merits further examination by larger, multicenter studies to confirm or refute the observations made in this pilot study.
authors.affiliation: Department of Gastroenterology, Walsgrave Hospital, Walsgrave, Coventry, United Kingdom.
authors.forename: Sheldon C
authors.initials: SC
authors.lastname: Cooper
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Hulley
authors.forename: Charles E
authors.initials: CE
authors.lastname: Grimley
authors.forename: Jane
authors.initials: J
authors.lastname: Howden
authors.forename: Karl
authors.initials: K
authors.lastname: McCluskey
authors.forename: Robert N
authors.initials: RN
authors.lastname: Norton
authors.forename: Chuka U
authors.initials: CU
authors.lastname: Nwokolo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000009:adverse effects; D010865:Pilot Projects; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D016896:Treatment Outcome