Mide kanseri nedeniyle rezeksiyon uygulanan hastalarda postoperatif erken enteral nütrisyon (EEN) ve total parenteral nütrisyonun (TPN) karşılaştırılması
A comparison of postoperative early enteral nutrition ((EEN)) and total parenteral nutrition (TPN) in patients with gastrectomy due to gastric adenocarcinoma
Yazar: OĞUZHAN ÖZŞAY
Danışman: PROF. DR. AKİF SERHAT GÜR
Sağlık Bakanlığı / İzmir Atatürk Eğitim ve Araştırma Hastanesi / Genel Cerrahi Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2004
Konu: Genel Cerrahi = General Surgery

Özet:
Giriş ve Amaç: Mide adenokarsinomu nedeniyle gastrektomi uygulanan hastalarda postoperatif erken enteral nütrisyon (EEN) ve total parenteral nütrisyonun (TPN) kısa dönem cerrahi sonuçlar üzerine etkisini araştırmak.

Gereç ve Yöntem: 2001-2004 yılları arasında mide adenokarsinomu nedeniyle gastrektomi uygulanan 26 hastadan oluşan prospektif kaydedilmiş database retrospektif değerlendirildi. Hastalar postoperatif erken enteral nütrisyon ve total parenteral nütrisyon uygulananlar olarak iki gruba ayrılarak incelendi. Primer sonlanım noktası hastanede kalış süresiydi. Sekonder sonlanım noktası diğer postoperatif morbiditeler idi.

Bulgular:  Hastaların  12'si EEN 14'ü TPN grubunda idi. Yaş ortalaması EEN grubunda 59 (46-75), TPN grubunda 63'dü (52-73). Preoperatif serum albumin EEN uygulananlarda 3.57 g/dl (2.80-4.78), TPN grubunda 3.26 g/dl (2.55-4.53) idi. EEN grubundaki iki hastaya total gastrektomi 10 hastaya subtotal gastrektomi uygulanırken, TPN grubundaki üç hastaya total gastrektorni, l l hastaya (%78.9) subtotal gastrektomi uygulanmıştı. Ameliyat süresi EEN grubunda 230.5 dakika (180-310) ve TPN grubunda 218.2 (175-310) dakika idi. EEN grubunda hastanede kalış süresi anlamlı daha kısa bulundu (p<0.05)

Sonuç: Gastrik adenokarsinom için gastrektomi sonrası EEN hastanede kalış süresini kıslatıyor gibi gözükmektedir.


Anahtar Kelimeler: Erken enteral nütrisyon. Total parenetral nütrisyon. Gastrektomi

Abstract:
Introduction and Aim: To investigate the effect of postoperative early enteral nutrition (EEN) and total parenteral nutrition (TPN) on short-term surgical outcomes in patients who underwent gastrectomy for gastric adenocarcinoma.

Materials and Methods: A prospectively recorded database of 26 patients who underwent gastrectomy for gastric adenocarcinoma between 2001 and 2004 was retrospectively evaluated. The patients were divided into two groups as those who received postoperative early enteral nutrition and those who received total parenteral nutrition. The primary endpoint was length of hospital stay. The secondary endpoint was other postoperative morbidities.

Results: Twelve of the patients were in the EEN group and 14 were in the TPN group. The mean age was 59 (46-75) in the EEN group and 63 (52-73) in the TPN group. Preoperative serum albumin was 3.57 g/dl (2.80-4.78) in the EEN group and 3.26 g/dl (2.55-4.53) in the TPN group. Total gastrectomy was performed in two patients in the EEN group, subtotal gastrectomy was performed in 10 patients, total gastrectomy was performed in three patients in the TPN group, and subtotal gastrectomy was performed in 11 patients (78.9%). The operative time was 230.5 minutes (180-310) in the EEN group and 218.2 (175-310) minutes in the TPN group. The length  of hospital stay was found to be significantly shorter in the EEN group (p<0.05)

Conclusion: EEN after gastrectomy for gastric adenocarcinoma seems to shorten the length of hospital stay.


Keywords: Early enteral nutrition. Total parenetral nutrition. Gastrectomy