在食管癌新辅助治疗后接受经食管切除术的患者中,比较空肠造口术和鼻空肠置管的单中心随机试验。

IF 1.6 Q4 ONCOLOGY
Journal of Gastrointestinal Cancer Pub Date : 2024-09-01 Epub Date: 2024-07-02 DOI:10.1007/s12029-024-01080-0
Lokesh Agarwal, Nihar Ranjan Dash, Sujoy Pal, Kumble Seetharama Madhusudhan, Vignesh Mani
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引用次数: 0

摘要

背景:肠内营养是食管切除术后的首选营养方式。然而,肠内营养的首选模式(喂养空肠造口术(FJ)与鼻空肠(NJ)管)仍存在争议。在这项随机对照试验(RCT)中,我们从安全性、可行性、疗效和生活质量(QOL)参数等方面比较了空肠造口术和鼻空肠插管喂养对因食管癌接受经食管裂孔食管切除术(THE)的印度患者的效果:这项单中心、双臂(FJ 管和 NJ 管)、非劣效性 RCT 于 2020 年 3 月至 2024 年 1 月进行。48名患者接受了后纵隔-胃牵拉术,并被随机分配到NJ和FJ两组(每组24人)。两组患者的术后并发症、导管疗效和 QOL 参数在 6 周随访前进行了比较:在这项研究中,我们发现食管癌患者在使用 NJ 管和 FJ 管后,导管相关并发症的发生率、术后并发症发生率、导管疗效和视觉模拟疼痛评分均无明显差异。在出院时(44.7 ± 6.2 vs 39.8 + 5.6;P 值,0.005)和 6 周随访时(55.4 ± 5.2 vs 48.6 ± 4.5;P 值,0.005),NJ 组的自我报告身体领域 QOL 评分明显更高:根据我们的 RCT 研究结果,我们得出结论:两种肠道入路方法(NJ 与 FJ)的导管相关并发症发生率相当。使用 NJ 管是手术 FJ 的可行替代方案,其优点是可以及早拔管,并可避免腹部插管带来的痛苦。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Single-Center Randomized Trial Comparing Feeding Jejunostomy with Nasojejunal Tube Placement in Patients Undergoing Transhiatal Esophagectomy Post-Neoadjuvant Therapy for Esophageal Cancer.

Background: Enteral nutrition is the preferred mode of nutrition following esophagectomy. However, the preferred mode of enteral nutrition (feeding jejunostomy (FJ) vs. nasojejunal (NJ) tube) remains contentious. In this randomized controlled trial (RCT), we compared FJ with NJ tube feeding in terms of safety, feasibility, efficacy, and quality-of-life (QOL) parameters in Indian patients undergoing trans-hiatal esophagectomy (THE) for carcinoma esophagus.

Materials and methods: This single-center, two-armed (FJ and NJ tube), non-inferiority RCT was conducted from March 2020 to January 2024. Forty-eight patients underwent THE with posterior-mediastinal-gastric pull-up and were randomized to NJ and FJ arms (24 in each group). The postoperative complications, catheter efficacy, and QOL parameters were compared between the two groups till the 6-week follow-up.

Results: In this RCT, we found no significant difference in the occurrence of catheter-related complications, postoperative complication rate, catheter efficacy, and visual analog pain scores between patients with NJ tube and FJ, following THE for esophageal cancer. There was a significantly better self-reported physical domain QOL score noted in the NJ group, both at the time of discharge (44.7 ± 6.2 vs 39.8 + 5.6; p value, 0.005) and at the 6-week follow-up (55.4 ± 5.2 vs 48.6 ± 4.5; p value, < 0.001).

Conclusion: Based on the findings of our RCT, we conclude that both enteral access methods (NJ vs. FJ) exhibit comparable incidences of catheter-related complications. The use of NJ tube is a viable alternative to a surgical FJ, has the benefit of early removal, and saves the distress associated with a tube per abdomen.

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来源期刊
CiteScore
3.80
自引率
0.00%
发文量
121
期刊介绍: The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology:  This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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