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Original Articles
- Peripheral vein infusions of amino acids prevent early postoperative weight loss after robot-assisted radical transmediastinal esophagectomy: a retrospective study in Japan
- Tomonori Narita, Kazuhiko Fukatsu, Satoshi Murakoshi, Reo Inoue, Kenichi Kono, Midori Noguchi, Nana Matsumoto, Shoh Yajima, Koichi Yagi, Yoshifumi Baba
- Ann Clin Nutr Metab 2025;17(2):149-155. Published online August 1, 2025
- DOI: https://doi.org/10.15747/ACNM.25.0012
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Graphical Abstract
Abstract
PDF
Supplementary Material - Purpose
Postoperative body weight loss (PBWL) is linked to poor long-term outcomes following esophagectomy for esophageal cancer, making perioperative nutrition critically important. Although minimally invasive procedures such as robot-assisted radical transmediastinal esophagectomy (RA-TME) have become more prevalent, less attention has been paid to perioperative nutritional management. This study evaluates the impact of intravenous (IV) amino acid infusions on PBWL in patients undergoing RA-TME.
Methods
We retrospectively analyzed 155 patients who underwent RA-TME for esophageal or esophagogastric junction cancer at our hospital between 2011 and 2022. Patients were divided into two groups: AA(+) (n=73, received IV amino acids between postoperative days 1–6) and AA(–) (n=82, did not receive IV amino acids). Oral or enteral nutrition was withheld until postoperative day 6. We compared nutrient intake, postoperative outcomes, and nutritional status between groups.
Results
Patient backgrounds, surgical outcomes, and complication rates were similar in both groups. However, the AA(+) group received significantly greater energy and nutrient intake. PBWL at 2 weeks post-surgery was significantly lower in the AA(+) group than in the AA(–) group (6.50% vs. 8.15%, P=0.0091).
Conclusion
IV amino acid infusion may help mitigate early PBWL after RA-TME.
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- The enteral feeding tube access route in esophageal cancer surgery in Japan: a retrospective cohort study
- Hiroyuki Kitagawa, Keiichiro Yokota, Tsutomu Namikawa, Kazuhiro Hanazaki
- Ann Clin Nutr Metab 2025;17(1):58-65. Published online April 1, 2025
- DOI: https://doi.org/10.15747/ACNM.25.0003
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Graphical Abstract
Abstract
PDF
- Purpose
Feeding catheter jejunostomy is a useful access route for early enteral nutrition during esophageal cancer surgery. However, it may lead to postoperative bowel obstruction associated with feeding jejunostomy (BOFJ). To prevent BOFJ, we introduced feeding catheter duodenostomy via the round ligament in 2018. This study aimed to compare the incidence of BOFJ and postoperative body weight changes between feeding catheter jejunostomy and duodenostomy.
Methods
A total of 109 patients who underwent thoracoscopic esophagectomy and gastric tube reconstruction for esophageal cancer at Kochi Medical School Hospital between March 2013 and November 2020 were included. Preoperative patient characteristics (age, sex, preoperative weight, body mass index, cancer stage, and preoperative treatment), surgical outcomes (operative time, blood loss, and postoperative complications [wound infection, pneumonia, anastomotic leakage, BOFJ]), and body weight changes at 1, 3, 6, and 12 months post-surgery were compared between the jejunostomy (J) and duodenostomy (D) groups.
Results
The D group consisted of 35 patients. No significant differences were observed between the groups regarding age, sex, weight, body mass index, cancer stage, operative time, postoperative complications, or duration of tube placement. However, the D group had a significantly lower rate of preoperative chemotherapy (45.7% vs. 78.4%, P=0.001) and lower operative blood loss (120 mL vs. 150 mL, P=0.046) than the J group. All 12 cases of BOFJ occurred in the J group. Furthermore, the D group experienced a significantly lower weight loss ratio at 1 month postoperatively (93.9% vs. 91.8%, P=0.039).
Conclusion
In thoracoscopic esophagectomy, feeding duodenostomy may prevent bowel obstruction and reduce early postoperative weight loss without increasing operative time compared with feeding catheter jejunostomy.
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