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Li R, Zhao Z, Huang H, Yu J. Bibliometric analysis of nutrition in gastric cancer from 2013 to 2023. Front Nutr 2024; 11:1402307. [PMID: 39360278 PMCID: PMC11444996 DOI: 10.3389/fnut.2024.1402307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 09/02/2024] [Indexed: 10/04/2024] Open
Abstract
Background Increasing evidence suggests that nutrition plays an important role in the treatment of gastric cancer. However, no bibliometrics analysis has been conducted in this field. Our study aimed to conduct a bibliometric study to explore the latest publishing trends and areas of intense activity within the sphere of nutrition in gastric cancer. Method Publications were extracted from the Web of Science Core Collection. CiteSpace (Version 6.2.4) and VOSviewer (Version 1.6.18) were used for visual analysis. Results In total, there were 441 publications authored by 2,941 authors from 809 organizations and 47 countries, published in 182 journals from 2013 to 2023. The most prolific country was China, and the most productive institution was the Chinese Academy of Medical Sciences. The leading core journal was Nutrients. P Daisuke Kobayashi and Yasuhiro Kodera were the most influential authors. The first highly cited document was published in Gastric Cancer by Kamarajah et al. The hotspots in this field were nutrition treatment and nutritional status. Moreover, research on nutritional status and nutrition-related prognosis in gastric cancer might be a potential trend. Conclusion Nutrition in gastric cancer is a burgeoning research field garnering increasing attention. Further investigation is necessary to better understand the impact of nutritional status on the prognosis of gastric cancer.
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Affiliation(s)
- Ruyin Li
- Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zirui Zhao
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Hongyun Huang
- Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jianchun Yu
- Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Yang Y, Ji H, Shi G. Comparison of nasojejunal nutrition and intravenous nutrition supplementation in patients with upper gastrointestinal tract strictures and analysis of risk factors for malnutrition. Medicine (Baltimore) 2024; 103:e38820. [PMID: 38968469 PMCID: PMC11224873 DOI: 10.1097/md.0000000000038820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 06/13/2024] [Indexed: 07/07/2024] Open
Abstract
This study examines the effectiveness of nasojejunal and intravenous nutrition in supplementing nutrition for patients with upper gastrointestinal (GI) strictures and analyzes the risk factors associated with malnutrition to provide references for clinical nutrition strategies. A retrospective analysis was conducted on 71 patients with upper GI strictures caused by esophageal and gastric cancers, who received nutritional support from January 2015 to January 2023. Out of these, 53 patients had complete baseline and follow-up data. We collected general clinical and perioperative data for comparison of the efficacy between nasojejunal nutrition and intravenous nutrition. Risk factors for malnutrition were analyzed using univariate and multivariate logistic regression. Malnutrition occurred in 24.53% (13/53) of the patients with upper GI strictures. The incidence of malnutrition was 6.06% (2/33) in the nasojejunal nutrition group compared to 55.00% (11/20) in the intravenous nutrition group, with a statistically significant difference (P < .001). Univariate and multivariate regression analyses identified diabetes (P < .001), initial blood K (P = .011), pathological staging (P < .001), and pathological grading (P < .001) as risk factors for malnutrition in patients with upper GI strictures. Diabetes (P = .028), initial blood K (P = .018), and pathological staging (P = .011) were found to be independent risk factors. Nasojejunal nutrition results in a lower incidence of malnutrition compared to intravenous nutrition in patients with upper GI strictures. Diabetes, initial blood K, pathological staging, and pathological grading are risk factors for malnutrition, with diabetes, initial blood K, and pathological staging serving as independent risk factors.
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Affiliation(s)
- Yunfei Yang
- Department of radiology, Peking University First Hospital—Miyun Hospital, Beijing, China
| | - Huirong Ji
- Department of radiology, Peking University First Hospital—Miyun Hospital, Beijing, China
| | - Guangyong Shi
- Department of radiology, Peking University First Hospital—Miyun Hospital, Beijing, China
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Wang C, Yang D. Effect of different preoperative nutritional treatments on postoperative recovery and clinical outcomes in patients with gastric cancer and early gastric outlet obstruction. Oncol Lett 2024; 27:214. [PMID: 38572061 PMCID: PMC10988191 DOI: 10.3892/ol.2024.14348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 02/20/2024] [Indexed: 04/05/2024] Open
Abstract
Patients with gastric cancer and early gastric outlet obstruction often experience malnutrition and require various nutritional support strategies. This study aimed to evaluate the impact of different preoperative nutritional treatments on their postoperative recovery and prognosis. The present retrospective study collected data from 467 patients with gastric cancer and early gastric outlet obstruction who underwent surgery at Harbin Medical University Cancer Hospital (Harbin, China) between January 2016 and December 2018. All patients received preoperative nutritional treatment, with a mean treatment duration of 8.23±2.33 days. The present study analyzed associations and survival in different groups using χ2, independent-samples t-test, ANOVA and log-rank tests. Furthermore, single- and multi-factor survival analyses were conducted and nomograms and calibration curves constructed to investigate factors influencing patient survival. In this study, 230 patients (49.3%) received only parenteral nutrition (PN; Group 1), 162 patients (34.7%) received PN combined with enteral nutrition (EN; Group 2) and 75 patients (16.0%) received PN combined with a full- or semi-liquid diet (Group 3). No significant differences in clinical and pathological parameters were observed among the groups. However, Group 2 showed significant advantages in postoperative recovery, including faster time to first postoperative bowel sounds, flatus and bowel movement. Survival analysis indicated that Group 3 had shorter progression-free survival (χ2=30.485) and overall survival (χ2=31.249). Preoperative nutritional treatment was identified as an independent prognostic factor. Preoperative PN combined with EN proved advantageous for postoperative recovery of patients with gastric cancer and early gastric outlet obstruction. Furthermore, PN combined with full- or semi-liquid diets may not have fully met the nutritional needs of these patients, resulting in less favorable clinical outcomes.
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Affiliation(s)
- Caixia Wang
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Dameng Yang
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
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Gao X, Zhang Y, Qi X, Xiao Y, Gao T, Jin G, Wang K, Zhou Y, Chi Q, Yang H, Li M, Yu J, Qin H, Tang Y, Wu X, Li G, Zhang L, Wang X. Early enteral nutrition versus early supplemental parenteral nutrition in patients undergoing major abdominal surgery: a secondary analysis of 2 randomized clinical trials. Am J Clin Nutr 2024; 119:1036-1043. [PMID: 38369126 DOI: 10.1016/j.ajcnut.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND The effect of early isoenergetic feeding routes [early enteral nutrition (E-EN) or early supplemental parenteral nutrition (E-SPN)] on the outcome of patients undergoing major abdominal surgery is controversial. OBJECTIVES The aim of this study was to investigate the impact of early isoenergetic EN compared with early isoenergetic SPN on nosocomial infections in patients undergoing major abdominal surgery. METHODS This study is a secondary, post hoc analysis of data from 2 open-label randomized clinical trials. Participants were recruited from the general surgery department of 11 academic hospitals in China undergoing major abdominal surgery and with Nutritional Risk Screening 2002 score ≥3. All eligible patients were categorized into 2 groups based on their achievement of the 100% energy target on postoperative day (POD) 3: the E-EN group (n = 199) and the E-SPN group (n = 115). The primary outcome was the incidence of nosocomial infections between POD 3 and hospital discharge. RESULTS In total, 314 patients [mean (SD) age, 59.2 (11.4) y; 113 (36.0%) females] were included. Patients in the E-EN group showed no significant difference in nosocomial infections compared with those in the E-SPN group {17/199 [8.5%] compared with 10/115 [8.7%], risk difference, 0.2% [95% confidence interval (CI): -6.3, 6.6]}. The hematological nutritional status of the E-EN group showed a significant improvement at discharge compared with the E-SPN group (albumin: 38.0 ± 6.0 g/L compared with 35.5 ± 7.6 g/L; mean difference, -2.5 g/L; 95% CI: -4.0, -1.0 g/L; prealbumin: 200.0 ± 8.0 mg/L compared with 158.4 ± 38.1 mg/L; mean difference, -41.6 mg/L; 95% CI: -41.7, -36.1 mg/L). Other indicators were comparable between groups. CONCLUSION E-EN compared with isoenergetic SPN may not be associated with a reduced rate of nosocomial infection in patients undergoing major abdominal surgery, but may be associated with improved hematological nutritional status. TRIAL REGISTRATION NUMBER This trial was registered at clinicaltrials.gov as NCT03115957 (https://clinicaltrials.gov/ct2/show/NCT03115957) and NCT03117348 (https://clinicaltrials.gov/ct2/show/NCT03117348).
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Affiliation(s)
- Xuejin Gao
- Department of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yupeng Zhang
- Department of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xin Qi
- Department of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yaqin Xiao
- Department of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Tingting Gao
- Department of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Gang Jin
- Department of Hepatobiliary Pancreatic Surgery, Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Kunhua Wang
- Department of General Surgery, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yanbing Zhou
- Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qiang Chi
- Department of General Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hua Yang
- Department of General Surgery, the Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Mengbin Li
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Jianchun Yu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Huanlong Qin
- Department of General Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yun Tang
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiaoting Wu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Guoli Li
- Department of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Li Zhang
- Department of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
| | - Xinying Wang
- Department of General Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
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Zhang Y, Zhang J, Zhu L, Hao J, He F, Xu T, Wang R, Zhuang W, Wang M. A Narrative Review of Nutritional Therapy for Gastrointestinal Cancer Patients Underwent Surgery. J INVEST SURG 2023; 36:2150337. [DOI: 10.1080/08941939.2022.2150337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- Yujie Zhang
- Center of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
| | - Jinglin Zhang
- Center of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
- Department of Gastrointestinal Surgery, Yibin Second People’s Hospital, Yibin, China
| | - Lili Zhu
- Center of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
| | - Jiaqi Hao
- Center of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
| | - Fengjun He
- Center of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Xu
- Center of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
- Department of General Surgery, Suining Municipal Hospital of Traditional Chinese Medicine, Suining, China
| | - Rui Wang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Wen Zhuang
- Center of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
| | - Mojin Wang
- Center of Gastric Cancer, West China Hospital, Sichuan University, Chengdu, China
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Issac A, Dhiraaj S, Halemani K, Thimmappa L, Mishra P, Kumar B, Mavinatop A. Efficacy of Early Enteral Nutrition on Gastrointestinal Surgery Outcomes: A Systematic Review and Meta-Analysis. Eur J Pediatr Surg 2023; 33:454-462. [PMID: 36724826 DOI: 10.1055/s-0043-1760837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Congenital anomalies, congenital malformations, or birth defects can be defined as any structural or functional anomalies that develop prenatally and could be identified before, at birth, or later in life. Approximately 6% of babies are born with a congenital anomaly, which results in 2.4 million newborn deaths worldwide. This systematic review and meta-analysis ascertained the quantitative studies published in PubMed, ClinicalKey, Embase, CINAHL, Cochrane Library, and Google Scholar. Two authors independently screened and extracted the data from the primary studies that analyzed the efficacy of early enteral nutrition (EEN) on the postoperative outcome. This systematic review and meta-analysis adopted Cochrane Collaboration guidelines and reported using the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement. The methodological quality of trials was assessed by Cochrane Collaboration's risk of bias tool. Six trials, representing 488 children, with age ranging from 10 days to 6.5 years, fulfilled the inclusion criteria. EEN has significantly shortened hospital stay, induced early fecal movement, and reduced postoperative wound infections in children with congenital gastrointestinal abnormalities undergoing gastrointestinal anastomosis compared with children who received late enteral nutrition. The review also found that the experimental group who received EEN had no significant impact on the anastomosis leakage, vomiting, and abdominal distension. EEN has some positive effects on postsurgery outcomes among children with congenital gastrointestinal anomalies undergoing gastrointestinal anastomosis.
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Affiliation(s)
- Alwin Issac
- College of Nursing, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India
| | - Sanjay Dhiraaj
- Department of Anesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kurvatteppa Halemani
- College of Nursing, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Latha Thimmappa
- College of Nursing, All India Institute of Medical Sciences Kalyani, Kalyani, West Bengal, India
| | - Prabhakar Mishra
- Department of Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Basant Kumar
- Department of Pediatric Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anusha Mavinatop
- Department Nutrition/Dietetic, JSS Medical College, Mysore, Karnataka, India
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Chen Z, Hong B, He JJ, Ye QQ, Hu QY. Examining the impact of early enteral nutritional support on postoperative recovery in patients undergoing surgical treatment for gastrointestinal neoplasms. World J Gastrointest Surg 2023; 15:2222-2233. [PMID: 37969702 PMCID: PMC10642466 DOI: 10.4240/wjgs.v15.i10.2222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/02/2023] [Accepted: 08/18/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Patients with gastrointestinal tumors often suffer from poor nutritional status during treatment. Surgery is the main treatment for these patients, but the long postoperative recovery period is often accompanied by digestive and absorption dysfunction, leading to further deterioration of the nutritional status. Early enteral nutrition support is hypothesized to be helpful in improving this situation, but the exact effects have yet to be studied in depth. AIM To observe the effect of early enteral nutritional support on postoperative recovery in patients with surgically treated gastrointestinal tract tumors, with the expectation that by improving the nutritional status of patients, the recovery process would be accelerated and the incidence of complications would be reduced, thus improving the quality of life. METHODS A retrospective analysis of 121 patients with gastrointestinal tract tumors treated in our hospital from January 2020 to January 2023 was performed. Fifty-three of these patients received complete parenteral nutrition support as the control group for this study. The other 68 patients received early enteral nutritional support as the observation group of this study. The clinical indicators comparing the two groups included time to fever, time to recovery of postoperative bowel function, time to postoperative exhaustion, and length of hospital stay. The changes in immune function and nutritional indexes in the two groups were compared. Furthermore, we utilized the SF-36 scale to compare the changes in the quality of life between the two groups of patients. Finally, the occurrence of postoperative complications between the two patient groups was also compared. RESULTS The postoperative fever time, postoperative bowel function recovery time, postoperative exhaustion time, and hospitalization time were all higher in the control group than in the observation group (P < 0.05). The levels of CD3+, CD4+, immunoglobulin (Ig) A, IgM, and IgG in the observation group were significantly higher than those in the control group at 1 d and 7 d postoperatively, while CD8+ was lower than in the control group (P < 0.05). Total protein, albumin, prealbumin, and transferrin levels were significantly higher in the observation group than in the control group at 7 d postoperatively (P < 0.05). The SF-36 scores of patients in the observation group were significantly higher than those in the control group (P < 0.0001). The overall incidence of adverse reactions after the intervention was significantly lower in the control group than in the observation group (P = 0.021). CONCLUSION We found that patients with gastrointestinal tumors are nutritionally vulnerable, and early enteral nutrition support programs can improve the nutritional status of patients and speed up postoperative recovery. This program can not only improve the immune function of the patient and protect the intestinal function, but it can also help to improve the quality of life of the patient. However, this program will increase the incidence of complications in patients. Caution should be taken when adopting early enteral nutrition support measures for patients with gastric cancer. The patient's condition and physical condition should be comprehensively evaluated and closely monitored to prevent possible complications.
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Affiliation(s)
- Zhi Chen
- Department of Rehabilitation, Xiangshan First People’s Hospital Medical and Health Group, Ningbo 315700, Zhejiang Province, China
| | - Bo Hong
- Department of Gastroenterology, Xiangshan First People’s Hospital Medical and Health Group, Ningbo 315700, Zhejiang Province, China
| | - Jiang-Juan He
- Center of Nursing Management, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| | - Qian-Qian Ye
- Department of Rehabilitation, Xiangshan First People’s Hospital Medical and Health Group, Ningbo 315700, Zhejiang Province, China
| | - Qiao-Yi Hu
- Department of Nutrition, Xiangshan First People’s Hospital Medical and Health Group, Ningbo 315700, Zhejiang Province, China
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Valla FV, Uberti T, Henry C, Slim K. Perioperative nutritional assessment and support in visceral surgery. J Visc Surg 2023; 160:356-367. [PMID: 37587003 DOI: 10.1016/j.jviscsurg.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Malnutrition in visceral surgery is frequent; it calls for screening prior to an operation, and its postoperative occurrence should be sought out and prevented, if possible. Organization of an individualized nutritional support strategy is based on systematic nutritional assessment and adapted to the type of surgery, the objectives being to forestall malnutrition and to reduce induced morbidity (immunosuppression, delayed wound healing, anastomotic fistulas…). Nutritional support is part and parcel of enhanced recovery after surgery (ERAS), and has shown effectiveness in the field of visceral surgery. Oral feeding should always be privileged to the greatest possible extent, complemented if necessary by nutritional supplements. If nutritional support is required, enteral nutrition should be favored over parenteral nutrition. As for the role of pharmaco-nutrition or immuno-nutrition, it remains ill-defined. Lastly, each type of visceral surgery entails specific modifications of the anatomy of the digestive system and is liable to have specific functional consequences, which should be known and taken into account in view of effectively tailoring nutritional support.
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Affiliation(s)
- Frederic V Valla
- Nutrition Support Team, Hospices Civils de Lyon, 69310 Lyon - Pierre-Bénite, France.
| | - Thomas Uberti
- Anesthesiology and Critical Care Department, Hôpital E.-Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - Caroline Henry
- Nutrition Support Team, Hospices Civils de Lyon, 69310 Lyon - Pierre-Bénite, France
| | - Karem Slim
- Digestive Surgery Department and Ambulatory Surgery Unit, 63003 Clermont-Ferrand, France
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Kuang F, Wang J, Wang BQ. Emergency exploratory laparotomy and radical gastrectomy in patients with gastric cancer combined with acute upper gastrointestinal bleeding. World J Gastrointest Surg 2023; 15:1423-1433. [PMID: 37555107 PMCID: PMC10405117 DOI: 10.4240/wjgs.v15.i7.1423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/07/2023] [Accepted: 05/24/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Gastric cancer (GC) is a prevalent malignant tumor worldwide and ranks as the fourth leading cause of cancer-related mortality. Upper gastrointestinal bleeding (UGIB) is a frequent complication of GC. Radical gastrectomy and palliative therapy are widely used surgical procedures in the clinical management of GC. This study intends to probe the clinical efficacy and safety of radical gastrectomy and palliative therapy on the basis of exploratory laparotomy in patients with GC combined with UGIB, hoping to provide valuable information to aid patients in selecting the appropriate surgical intervention. AIM To investigate the clinical efficacy and safety of exploratory laparotomy + radical gastrectomy and palliative therapy in patients with GC and UGIB combined. METHODS A total of 89 GC patients admitted to the First Affiliated Hospital of the University of South China between July 2018 and July 2020 were selected as participants for this study. The 89 patients were divided into two groups: radical resection group (n = 46) treated with exploratory laparotomy + radical gastrectomy and Palliative group (n = 43) treated with palliative therapy. The study compared several variables between the two groups, including surgical duration, intraoperative blood transfusion volume, postoperative anal exhaust time, off-bed activity time, length of hospitalization, and incidence of complications such as duodenal stump rupture, anastomotic obstruction, and postoperative incision. Additionally, postoperative immune function indicators (including CD3+, CD4+, CD8+, CD4+/CD8+, and CD3+/HLADR+), immunoglobulin (IgG and IgM), tumor markers (CEA, CA199, and CA125), and inflammatory factors (IL-6, IL-17, and TNF-α) were assessed. The surgical efficacy and postoperative quality of life recovery were also evaluated. The patients were monitored for survival and tumor recurrence at 6 mo, 1 year, and 2 years post-surgery. RESULTS The results indicated that the duration of operation time and postoperative hospitalization did not differ between the two surgical procedures. However, patients in the radical resection group exhibited shorter intraoperative blood loss, anus exhaust time, off-bed activity time, and inpatient activity time than those in the Palliative group. Although there was no substantial difference in the occurrence of postoperative complications, such as duodenal stump rupture and anastomotic obstruction, between the radical resection group and Palliative group (P > 0.05), the radical resection group exhibited higher postoperative immune function indicators (including CD3+, CD4+, CD8+, etc.) and immunoglobulin levels (IgG, IgM) than the Palliative group, while tumor markers and inflammatory factors levels were lower than those in the radical resection group. Additionally, surgical efficacy, postoperative quality of life, and postoperative survival rates were higher in patients who underwent radical gastrectomy than in those who underwent palliative therapy. Moreover, the probability of postoperative tumor recurrence was lower in the radical gastrectomy group compared to the palliative therapy group, and these differences were all statistically significant (P < 0.05). CONCLUSION Compared to palliative therapy, exploratory laparotomy + radical gastrectomy can improve immune function, reduce the levels of tumor markers and inflammatory factors, improve surgical efficacy, promote postoperative quality of life recovery, enhance survival rates, and attenuate the probability of tumor recurrence.
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Affiliation(s)
- Feng Kuang
- Department of Emergency, The First Affiliated Hospital of University of South China, Hengyang 421001, Hunan Province, China
| | - Jian Wang
- Department of Emergency, The First Affiliated Hospital of University of South China, Hengyang 421001, Hunan Province, China
| | - Bai-Qi Wang
- Department of Radiation Oncology, The Second Affiliated Hospital of University of South China, Hengyang 421001, Hunan Province, China
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10
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Jiang X, Chen J, Yuan X, Lin Y, Chen Y, Li S, Jiang Q, Yu H, Du Q, Peng J. Feasibility of an Individualized mHealth Nutrition (iNutrition) Intervention for Post-Discharged Gastric Cancer Patients Following Gastrectomy: A Randomized Controlled Pilot Trial. Nutrients 2023; 15:nu15081883. [PMID: 37111102 PMCID: PMC10144256 DOI: 10.3390/nu15081883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
(1) Background: A major challenge for post-discharged gastric cancer patients following gastrectomy is the impact of the anatomy change on decreased oral intake, nutritional status, and, ultimately, quality of life. The purpose of this study is to examine the feasibility and preliminary effects of an individualized mHealth nutrition (iNutrition) intervention in post-discharged gastric cancer patients following gastrectomy. (2) Methods: A mixed-method feasibility study with a parallel randomized controlled design was conducted. Patients were randomly assigned to either the iNutrition intervention group (n = 12) or the control group (n = 12). Participants completed measures at baseline (T0), four (T1), and twelve weeks (T2) post-randomization. (3) Results: Recruitment (33%) and retention (87.5%) rates along with high adherence and acceptability supported the feasibility of the iNutrition intervention for post-discharged gastric cancer patients following gastrectomy, echoed by the qualitative findings. The iNutrition intervention significantly improved participants' nutritional behavior (p = 0.005), energy intake (p = 0.038), compliance with energy requirements (p = 0.006), and compliance with protein requirements (p = 0.008). (4) Conclusions: The iNutrition intervention is feasible and potentially benefits post-discharged gastric cancer patients following gastrectomy. A larger trial is required to establish the efficacy of this approach. Trial Registration: 19 October 2022 Chinese Clinical Trial Registry, ChiCTR2200064807.
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Affiliation(s)
- Xiaohan Jiang
- School of Nursing, Sun Yat-sen University, Guangzhou 510006, China
| | - Jiamin Chen
- Department of Gastric Surgery, Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
- Department of Clinical Nutrition, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
| | - Xiuhong Yuan
- Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510006, China
| | - Yijia Lin
- Department of Gastric Surgery, Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
| | - Yingliang Chen
- Department of Gastric Surgery, Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
| | - Sijia Li
- Department of Gastric Surgery, Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
| | - Qiuxiang Jiang
- Department of Gastric Surgery, Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
| | - Hong Yu
- Department of Gastric Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510006, China
| | - Qianqian Du
- School of Nursing, Sun Yat-sen University, Guangzhou 510006, China
| | - Junsheng Peng
- School of Nursing, Sun Yat-sen University, Guangzhou 510006, China
- Department of Gastric Surgery, Department of General Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510006, China
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Porter J. Contemporary syntheses in nutrition and dietetics. Nutr Diet 2022; 79:4-5. [PMID: 35233910 DOI: 10.1111/1747-0080.12725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Judi Porter
- Deakin University, Geelong, Victoria, Australia.,Editor in Chief, Nutrition & Dietetics
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