title: Is a Central Venous Catheter Necessary for the Perioperative Management of Esophagectomy? A Prospective Randomized Pilot Study Comparing Two Different Perioperative Regimens.
abstract: OBJECTIVE
  Our prospective randomized study examined the possibility of perioperative management of esophagectomy without a central venous catheter (CVC).
  
  
  METHODS
  Forty patients who underwent esophagectomy for esophageal cancer were divided into the total parenteral nutrition (TPN; receiving conventional perioperative management via a CVC) and peripheral parenteral nutrition (PPN; receiving perioperative management without a CVC) groups. Albumin and retinol-binding protein (RBP) levels were used as measurements of the nutritional status. Early postoperative complications and catheter-related complications were also evaluated.
  
  
  RESULTS
  The actual calories administered per kg of body weight and the albumin and RBP levels did not significantly differ between the groups. Additionally, there was no significant difference in the morbidity of early postoperative complications between the groups. Catheter-related complications were observed in 4 patients in the TPN group (2 catheter infections, 1 case of thrombosis, and 1 case of iatrogenic pneumothorax), and 4 cases of peripheral phlebitis occurred in the PPN group. The incidence of catheter-related complications did not significantly differ between the groups.
  
  
  CONCLUSIONS
  Perioperative management without a CVC can be safely performed in esophagectomy patients, and the decision to insert a CVC should be made based on the patient's perioperative condition.
authors.affiliation: Department of Esophageal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Saito
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Nakajima
authors.forename: Kenro
authors.initials: K
authors.lastname: Kawada
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tokairin
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Kawano
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002406:Catheterization, Peripheral / Q000009:adverse effects; D002149:Energy Intake; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010289:Parenteral Nutrition, Total / Q000379:methods*; D019990:Perioperative Care / Q000379:methods*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012177:Retinol-Binding Proteins / Q000378:metabolism; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D012177:Retinol-Binding Proteins; D012709:Serum Albumin