Significance of Home Enteral Nutritional Support in Patients after Surgery for Esophageal Cancer

Michihiko Kitamura, Shichisaburo Abo, Masaji Hashimoto, Keiichi Izumi, Keisuke Kimura, Hidekazu Matsumoto

Second Department of Surgery, Akita University School of Medicine

The purpose of this study was to assess the long-term nutritional condition of patients after esophagectomy and evaluate the significance of the home enteral nutritional support (HENS) that we started in 1989. From April 1989 to October 1992,79 patients with no preoperative therapy underwent resection for esophageal cancer. Mean oral intake at discharge was 861 kcal/day. Enteral nutritional support was performed in 68 cases (86%) with a mean energy level of 671kcal/day. As a result, mean total intake of energy increased to 1439 kcal/day, which corresponded to 124% of the basal energy expenditure calculated by the Harris-Benedict formula. Fifty-one of these patients were followed, and HENS was performed in 42 cases (82%) with a mean energy intake of 486 kcal/day. The mean period of HENS was 5.4 months. Mean body weight of patients up to 36 months after discharge stayed at the same level as that at discharge. Mean values of serum total protein and albumin rose 1 month after discharge and remained within the normal ranges. The mean values of serum total cholesterol gradually increased after discharge. Mean values of total lymphocyte count in peripheral blood remained within the normal ranges. Mean values of % tricuspid skinfold thickness (% TSF) ranged from 62 to 80%, and about 70% of patients experienced severe or moderate loss of body fatty tissue. Mean values of % arm muscle circumference (% AMC) ranged from 80 to 90%. Conclusions: HENS is considered to be useful for the maintenance of body weight and improvement of laboratory tests. Based on the results of % TSF, more aggressive nutritional support should be performed for improving the loss of body fatty tissue.

Key words
esophageal cancer, postoperative nutritional assessment, home enteral nutritional support

Reprint requests
Michihiko Kitamura Second Department of Surgery, Akita University School of Medicine
1-1-1 Hondo, Akita, 010 JAPAN

Accepted
June 14, 1995

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