Nutrición enteral precoz en pacientes con gastrectomía total por cáncer

Background: Total parenteral nutrition has a high cost and frequency of complications. Enteral feeding is a feasible alternative that can be started early in the postoperative period. Aim: To assess digestive tolerance to early enteral feeding in cancer patients undergoing total gastrectomy and to c...

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Autores principales:	Papapietro V,Karin, Díaz G,Emma, Csendes J,Attila, Díaz J,Juan C, Burdiles P,Patricio, Maluenda G,Fernando, Braghetto M,Italo, Llanos B,José L, D'Acuña A,Sonia, Rappoport S,Jaime
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2002
Materias:	Enteral nutrition Gastrectomy Neoplasms by site Nutritional support Parenteral nutrition
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872002001000006
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spelling	oai:scielo:S0034-988720020010000062014-08-21Nutrición enteral precoz en pacientes con gastrectomía total por cáncerPapapietro V,KarinDíaz G,EmmaCsendes J,AttilaDíaz J,Juan CBurdiles P,PatricioMaluenda G,FernandoBraghetto M,ItaloLlanos B,José LD'Acuña A,SoniaRappoport S,Jaime Enteral nutrition Gastrectomy Neoplasms by site Nutritional support Parenteral nutrition Background: Total parenteral nutrition has a high cost and frequency of complications. Enteral feeding is a feasible alternative that can be started early in the postoperative period. Aim: To assess digestive tolerance to early enteral feeding in cancer patients undergoing total gastrectomy and to compare early enteral feeding (EEF) with total parenteral nutrition plus enteral feeding (TPN+EF), initiated after overcoming postoperative ileus. Patients and methods: Subjects with a resectable gastric cancer were considered eligible for the study. During surgery a nasoenteral tube was placed and patients were prospectively randomized to EEF or TPN+EF. Digestive tolerance, effectiveness, complications and costs between both modalities of nutritional support were compared. Results: Twenty eight patients (15 male, aged 63±14 years old) were studied. Fourteen patients were randomized to EEF and 14 to TPN+EF. Diarrhea occurred in 14 and 29% of EEF and TPN+EF patients respectively, (p: NS). Patients with TPN+EF received an average of 28 Cal/kg/day and 1.1 g/kg/day proteins. Patients with EEF received an average of 29 Cal/kg/day and 0.8 g/kg/day proteins. At the eighth postoperative day, serum albumin was 3.9±0.7 and 3.2±0.5 g/dl in EEF and TPN+EF patients respectively (p <0.05), serum prealbumin was 16.9±5 and 12.3±4.3 mg/dl in EEF and TPN+EF patients respectively (p <0.05) and nitrogen balance was +2.4±1.5 and -1.6±0.6 g/24 h in EEF and TPN+EF patients respectively (p <0.05). Postoperative hyperglycemia was observed with a lower frequency and nutritional support costs and length of hospital stay were significantly lower in the EEF group. Conclusions: After total gastrectomy EEF is well tolerated, safe and effective, even during the early postoperative ileus. This therapeutic modality could be the first choice for nutritional support in these patients (Rev Méd Chile 2002; 130: 1125-30)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.130 n.10 20022002-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872002001000006es10.4067/S0034-98872002001000006
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Enteral nutrition Gastrectomy Neoplasms by site Nutritional support Parenteral nutrition
spellingShingle	Enteral nutrition Gastrectomy Neoplasms by site Nutritional support Parenteral nutrition Papapietro V,Karin Díaz G,Emma Csendes J,Attila Díaz J,Juan C Burdiles P,Patricio Maluenda G,Fernando Braghetto M,Italo Llanos B,José L D'Acuña A,Sonia Rappoport S,Jaime Nutrición enteral precoz en pacientes con gastrectomía total por cáncer
description	Background: Total parenteral nutrition has a high cost and frequency of complications. Enteral feeding is a feasible alternative that can be started early in the postoperative period. Aim: To assess digestive tolerance to early enteral feeding in cancer patients undergoing total gastrectomy and to compare early enteral feeding (EEF) with total parenteral nutrition plus enteral feeding (TPN+EF), initiated after overcoming postoperative ileus. Patients and methods: Subjects with a resectable gastric cancer were considered eligible for the study. During surgery a nasoenteral tube was placed and patients were prospectively randomized to EEF or TPN+EF. Digestive tolerance, effectiveness, complications and costs between both modalities of nutritional support were compared. Results: Twenty eight patients (15 male, aged 63±14 years old) were studied. Fourteen patients were randomized to EEF and 14 to TPN+EF. Diarrhea occurred in 14 and 29% of EEF and TPN+EF patients respectively, (p: NS). Patients with TPN+EF received an average of 28 Cal/kg/day and 1.1 g/kg/day proteins. Patients with EEF received an average of 29 Cal/kg/day and 0.8 g/kg/day proteins. At the eighth postoperative day, serum albumin was 3.9±0.7 and 3.2±0.5 g/dl in EEF and TPN+EF patients respectively (p <0.05), serum prealbumin was 16.9±5 and 12.3±4.3 mg/dl in EEF and TPN+EF patients respectively (p <0.05) and nitrogen balance was +2.4±1.5 and -1.6±0.6 g/24 h in EEF and TPN+EF patients respectively (p <0.05). Postoperative hyperglycemia was observed with a lower frequency and nutritional support costs and length of hospital stay were significantly lower in the EEF group. Conclusions: After total gastrectomy EEF is well tolerated, safe and effective, even during the early postoperative ileus. This therapeutic modality could be the first choice for nutritional support in these patients (Rev Méd Chile 2002; 130: 1125-30)
author	Papapietro V,Karin Díaz G,Emma Csendes J,Attila Díaz J,Juan C Burdiles P,Patricio Maluenda G,Fernando Braghetto M,Italo Llanos B,José L D'Acuña A,Sonia Rappoport S,Jaime
author_facet	Papapietro V,Karin Díaz G,Emma Csendes J,Attila Díaz J,Juan C Burdiles P,Patricio Maluenda G,Fernando Braghetto M,Italo Llanos B,José L D'Acuña A,Sonia Rappoport S,Jaime
author_sort	Papapietro V,Karin
title	Nutrición enteral precoz en pacientes con gastrectomía total por cáncer
title_short	Nutrición enteral precoz en pacientes con gastrectomía total por cáncer
title_full	Nutrición enteral precoz en pacientes con gastrectomía total por cáncer
title_fullStr	Nutrición enteral precoz en pacientes con gastrectomía total por cáncer
title_full_unstemmed	Nutrición enteral precoz en pacientes con gastrectomía total por cáncer
title_sort	nutrición enteral precoz en pacientes con gastrectomía total por cáncer
publisher	Sociedad Médica de Santiago
publishDate	2002
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872002001000006
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Nutrición enteral precoz en pacientes con gastrectomía total por cáncer

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