Changes in the nutritional status of elderly patients after esophagectomy
Tóm tắt
Esophagectomy is a highly invasive procedure for patients aged > 70 years. Here, we compared the actual nutritional status of older and younger patients who underwent esophagectomy. A total of 118 patients who underwent radical esophagectomy between April 2013 and December 2016 were enrolled and divided into two groups based on age: group A (n = 41; ≥ 70 years) and group B (n = 77; < 70 years). Data pertaining to body mass index and nutritional variables (albumin; total cholesterol; cholinesterase; and prealbumin) were retrospectively analyzed preoperatively and at 3, 6, and 12 months postoperatively. Significant preoperative between-group differences were found in the cholinesterase, albumin, and prealbumin levels. The body mass index gradually decreased over the first 12 months after surgery in both groups, without significant between-group differences. Significant differences were observed in prealbumin and cholinesterase levels at 3 months postoperatively. 1 year postoperatively, both groups showed slight improvements; however, the between-group differences were not statistically significant. Group A had a significantly lower amount of the degree of decrement of BMI and chE than group B. Thus, patients aged > 70 years can recover within 12 months of esophagectomy.
Tài liệu tham khảo
Wright CD, Kucharczuk JC, O’Brien SM, et al. Society of thoracic surgeons general thoracic surgery database. Predictors of major morbidity and mortality after esophagectomy for esophageal cancer: a society of thoracic surgeons general thoracic surgery database risk adjustment model. J Thorac Cardiovasc Surg. 2009;137:587–95.
Martin L, Lagergren P. Long-term weight change after oesophageal cancer surgery. Br J Surg. 2009;96:1308–14.
Internullo E, Moons J, Nafteux P, et al. Outcome after esophagectomy for cancer of the esophagus and GEJ in patients over 75 years. Eur J Cardiothorac Surg. 2008;33:1096–104.
Carey S, Storey D, Biankin AV, et al. Long term nutritional status and quality of life following major upper gastrointestinal surgery: a cross-sectional study. Clin Nutr. 2011;30:774–9.
Bae J, Kim S, Kim Y, et al. Health-related quality of life among disease-free stomach cancer survivors in Korea. Qual Life Res. 2006;15:1587–96.
Conroy T, Uwer L, Deblock M. Health-related quality-of-life assessment in gastrointestinal cancer: are results relevant for clinical practice? Curr Opin Oncol. 2007;19:401–6.
Huang JJ, Yeo CJ, Sohn TA, et al. Quality of life and outcomes after pancreaticoduodenectomy. Ann Surg. 2000;231:890–8.
Senesse P, Assenat E, Schneider S, et al. Nutritional support during oncologic treatment of patients with gastrointestinal cancer: who could benefit? Cancer Treat Rev. 2008;34:568–75.
Yu W, Seo Y, Chung H. Postoperative body weight loss and survival after curative resection for gastric cancer. Br J Surg. 2002;89:467–70.
United Nations. Department of Economic and Social Affairs, Population Division. In: World Population to 2300. New York: United Nations. 2004. http://www.un.org/esa/population/publications/longrange2/WorldPop2300final.pdf. Accessed December 2012.
LoCicero J III, Shaw PJ. Thoracic surgery in the elderly: areas of future research studies. Thorac Surg Clin. 2009;19:409–13.
Cijs TM, Verhoef C, Steyerberg EW, et al. Outcome of esophagectomy for cancer in elderly patients. Ann Thorac Surg. 2010;90:900–7.
Morita M, Egashira A, Yoshida R, et al. Esophagectomy in patients 80 years of age and older with carcinoma of the thoracic esophagus. J Gastroenterol. 2008;43:345–51.
Pultrum BB, Bosch DJ, Nijsten MW, et al. Extended esophagectomy in elderly patients with esophageal cancer: minor effect of age alone in determining the postoperative course and survival. Ann Surg Oncol. 2010;17:1572–80.
Fang W, Igaki H, Tachimori Y, et al. Three field lymph node dissection for esophageal cancer in elderly patients over 70 years of age. Ann Thorac Surg. 2001;72:867–71.
Tapias LF, Muniappan A, Wright CD, et al. Short and long-term outcomes after esophagectomy for cancer in elderly patients. Ann Thorac Surg. 2013;95:1741–8.
Conroy T, Uwer L, Deblock M. Health-related quality-of-life assessment in gastrointestinal cancer: are results relevant for clinical practice? Curr Opin Oncol. 2007;19:401–6.
Huang JJ, Yeo CJ, Sohn TA, et al. Quality of life and outcomes after pancreaticoduodenectomy. Ann Surg. 2000;231:890–8.
Carey S, Ferrie S, Ryan R, et al. Long-term nutrition intervention following major upper gastrointestinal surgery: a prospective randomized controlled trial. Eur J Clin Nutr. 2013;67:324–9.
Devoto G, Gallo F, Marchello C, et al. Prealbumin serum concentrations as a useful tool in the assessment of malnutrition in hospitalized patients. Clin Chem. 2006;52:2281–5.