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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorJanssen, Henricus J. B.
dc.contributor.authorGantxegi Madina, Amaia
dc.contributor.authorFransen, Laura F. C.
dc.contributor.authorNieuwenhuijzen, Grard A. P.
dc.contributor.authorLuyer, Misha D. P.
dc.date.accessioned2022-05-06T12:55:27Z
dc.date.available2022-05-06T12:55:27Z
dc.date.issued2021-10
dc.identifier.citationJanssen HJB, Gantxegi A, Fransen LFC, Nieuwenhuijzen GAP, Luyer MDP. Risk Factors for Failure of Direct Oral Feeding Following a Totally Minimally Invasive Esophagectomy. Nutrients. 2021 Oct;13(10):3616.
dc.identifier.issn2072-6643
dc.identifier.urihttp://hdl.handle.net/11351/7493
dc.descriptionEsophageal cancer; Jejunostomy; Nutrition
dc.description.abstractRecently, it has been shown that directly starting oral feeding (DOF) from postoperative day one (POD1) after a totally minimally invasive Ivor-Lewis esophagectomy (MIE-IL) can further improve postoperative outcomes. However, in some patients, tube feeding by a preemptively placed jejunostomy is necessary. This single-center cohort study investigated risk factors associated with failure of DOF in patients that underwent a MIE-IL between October 2015 and April 2021. A total of 165 patients underwent a MIE-IL, in which DOF was implemented in the enhanced recovery after surgery program. Of these, 70.3% (n = 116) successfully followed the nutritional protocol. In patients in which tube feeding was needed (29.7%; n = 49), female sex (compared to male) (OR 3.5 (95% CI 1.5–8.1)) and higher ASA scores (III + IV versus II) (OR 2.2 (95% CI 1.0–4.8)) were independently associated with failure of DOF for any cause. In case of failure, this was either due to a postoperative complication (n = 31, 18.8%) or insufficient caloric intake on POD5 (n = 18, 10.9%). In the subgroup of patients with complications, higher ASA scores (OR 2.8 (95% CI 1.2–6.8)) and histological subtypes (squamous-cell carcinoma versus adenocarcinoma and undifferentiated) (OR 5.2 (95% CI 1.8–15.1)) were identified as independent risk factors. In the subgroup of patients with insufficient caloric intake, female sex was identified as a risk factor (OR 5.8 (95% CI 2.0–16.8)). Jejunostomy-related complications occurred in 17 patients (10.3%). In patients with preoperative risk factors, preemptively placing a jejunostomy may be considered to ensure that nutritional goals are met.
dc.language.isoeng
dc.publisherMDPI
dc.relation.ispartofseriesNutrients;13(10)
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectEsòfag - Cirurgia - Complicacions
dc.subjectCirurgia endoscòpica
dc.subjectAlimentació
dc.subject.meshEsophagectomy
dc.subject.mesh/adverse effects
dc.subject.meshMinimally Invasive Surgical Procedures
dc.subject.meshEating
dc.titleRisk Factors for Failure of Direct Oral Feeding Following a Totally Minimally Invasive Esophagectomy
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.3390/nu13103616
dc.subject.decsesofagectomía
dc.subject.decs/efectos adversos
dc.subject.decsprocedimientos quirúrgicos mínimamente invasivos
dc.subject.decsingestión de alimentos
dc.relation.publishversionhttps://doi.org/10.3390/nu13103616
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Janssen HJB, Fransen LFC, Nieuwenhuijzen GAP, Luyer MDP] Department of Surgery, Catharina Hospital, 5602ZA Eindhoven, The Netherlands. [Gantxegi A] Servei de Cirurgia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain
dc.identifier.pmid34684617
dc.identifier.wos000715144200001
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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