[Clinical efficacy of carbohydrate preloading in reconstructive esophageal surgery].

Abstract

Objective: To evaluate clinical efficacy of preoperative carbohydrate loading as a component of ERAS in esophageal reconstructive surgery.

Material and methods: Post hoc analysis included 162 patients who underwent esophageal reconstructive interventions with ERAS principles between 2014 and 2024. The main group (n=61, CHO+) included patients who were metabolically loaded with carbohydrates in preoperative period with 12.5% maltodextrin solution 800 mL the day before and 400 mL 2 hours before surgery per os or enterally. The control group consisted of patients without carbohydrate load (n=101, CHO-). Primary endpoint was length of hospital-stay, secondary control points - postoperative glycemia and complication rate.

Results: Both groups were comparable in sex, age, character of the main and comorbid diseases, body mass index. Patients with CHO had significant lower incidence of respiratory complications (p=0.034). Both groups did not differ in the incidence of anastomosis failure, morbidity and mortality.

Conclusion: Preoperative carbohydrate loading in esophageal reconstructive surgery positively affects metabolic status and reduces the incidence of respiratory complications without effect on length of hospital-stay.