title: Effect of Early Full-Calorie Nutrition Support Following Esophagectomy: A Randomized Controlled Trial.
abstract: Early use of enteral nutrition (EN) is indicated following surgical resection of esophageal cancer. However, early EN support does not always meet the optimal calorie or protein requirements, and the benefits of supplementary parenteral nutrition (PN) remain unclear. We aimed to evaluate the efficacy and safety of early supplementary PN following esophagectomy.
  
  
  
  We enrolled 80 consecutive patients who underwent esophagectomy. Resting energy expenditure and body composition measurements were performed in all patients preoperatively and postoperatively. EN was administered after surgery, followed by randomization to either EN+PN or EN alone. The amount of PN administered was calculated to meet the full calorie requirement, as measured by indirect calorimetry, and 1.5 g protein/kg fat-free mass (FFM) per day was added as determined by body composition measurement. The clinical characteristics were compared between the 2 groups.
  
  
  
  Patients in the EN+PN group but not in the EN group preserved body weight (0.18 ± 3.38 kg vs -2.15 ± 3.19 kg, P < .05) and FFM (1.46 ± 2.97 kg vs -2.08 ± 4.16 kg) relative to preoperative measurements. Length of hospital stay, postoperative morbidity rates, and standard blood biochemistry profiles were similar. However, scores for physical functioning (71.5 ± 24.3 vs 60.4 ± 27.4, P < .05) and energy/fatigue (62.9 ± 19.5 vs 54.2 ± 23.5, P < .05) were higher in the EN+PN group 90 days following surgery.
  
  
  
  Early use of supplemental PN to meet full calorie requirements of patients who underwent esophagectomy led to better quality of life 3 months after surgery. Moreover, increased calorie and protein supplies were associated with preservation of body weight and FFM.
authors.affiliation: 1 Intensive Care Unit, Zhongshan Hospital Affiliated to Shanghai Fudan University School of Medicine, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.affiliation: 1 Intensive Care Unit, Zhongshan Hospital Affiliated to Shanghai Fudan University School of Medicine, Shanghai, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhong
authors.affiliation: 1 Intensive Care Unit, Zhongshan Hospital Affiliated to Shanghai Fudan University School of Medicine, Shanghai, China.
authors.forename: Du-Ming
authors.initials: DM
authors.lastname: Zhu
authors.affiliation: 1 Intensive Care Unit, Zhongshan Hospital Affiliated to Shanghai Fudan University School of Medicine, Shanghai, China.
authors.forename: Jie-Qiong
authors.initials: JQ
authors.lastname: Song
authors.affiliation: 1 Intensive Care Unit, Zhongshan Hospital Affiliated to Shanghai Fudan University School of Medicine, Shanghai, China.
authors.forename: Jun-Feng
authors.initials: JF
authors.lastname: Huang
authors.affiliation: 2 Department of Thoracic Surgery, Zhongshan Hospital Affiliated to Shanghai Fudan University School of Medicine, Shanghai, China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Wang
authors.affiliation: 2 Department of Thoracic Surgery, Zhongshan Hospital Affiliated to Shanghai Fudan University School of Medicine, Shanghai, China.
authors.forename: Li-Jie
authors.initials: LJ
authors.lastname: Tan
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001823:Body Composition; D001825:Body Fluid Compartments; D001835:Body Weight; D004044:Dietary Proteins / Q000008:administration & dosage / Q000627:therapeutic use*; D019587:Dietary Supplements; D002149:Energy Intake; D004734:Energy Metabolism; D004750:Enteral Nutrition; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects; D005221:Fatigue; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D010288:Parenteral Nutrition; D011183:Postoperative Complications; D011502:Protein-Energy Malnutrition / Q000209:etiology / Q000517:prevention & control*; D011788:Quality of Life
chemical_list: D004044:Dietary Proteins
keywords: body composition; esophagectomy; fat-free mass; supplementary parenteral nutrition