Analysis of the associated factors for severe weight loss after minimally invasive McKeown esophagectomy.

Abstract:

BACKGROUND:This study investigated the risk factors for severe weight loss (SWL) within one year after minimally invasive McKeown esophagectomy. METHODS:Esophageal cancer patients who underwent McKeown esophagectomy between January and July 2017 were prospectively enrolled. Preoperative body weight (PBW) was chosen as the initial body weight. RESULTS:Forty-four patients were enrolled and successfully followed up for one year. Median weight loss was 7.4% (quartile: 5.3-8.1%) and 12.6% (quartile: 8.8-17.7%) four weeks and one year after surgery, respectively. Accelerated weight loss occurred during the first two weeks after discharge, with median weight loss of 5.6% (quartile: 4.2-7.1%). Multivariable analysis showed that age ≥ 70 years (odds ratio [OR] 7.65; P = 0.030), preoperative sarcopenia (OR 7.18; P = 0.030), the first surgery in the daily schedule (OR 6.87; P = 0.032) and vocal cord paralysis (OR 12.30; P = 0.046) were independent risk factors for short-term (4 weeks) SWL (> 7.5% PBW), while an American Society of Anesthesiologists score of 3-4 (OR 6.58; P = 0.047), a high fat-free mass (OR 21.91; P = 0.003), and vocal cord paralysis (OR 25.83; P = 0.017) were independent risk factors for long-term (1 year) SWL (> 13.0% PBW) after esophagectomy. Postoperative symptoms of insomnia, appetite loss, dysphagia, eating difficulties, and taste issues were also related to SWL. CONCLUSIONS:In esophageal cancer patients who have undergone esophagectomy, the first two weeks after hospital discharge is a key period for nutrition intervention. Patients with associated factors for SWL require postoperative nutrition support.

journal_name

Thorac Cancer

journal_title

Thoracic cancer

authors

Wang P,Li Y,Sun H,Zhang R,Liu X,Liu S,Wang Z,Zheng Y,Yu Y,Chen X,Li H,Zhang J,Liu Q

doi

10.1111/1759-7714.12934

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

209-218

issue

2

eissn

1759-7706

issn

1759-7714

journal_volume

10

pub_type

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