Abstract
ObjectiveTo evaluate the safety of early oral feeding in patients with type II diabetes after radical resection of esophageal carcinoma.MethodsThe clinical data of 121 patients with type II diabetes who underwent radical resection of esophageal carcinoma in the department of cardiothoracic surgery of Jinling Hospital from January 2016 to December 2018 were retrospectively analyzed. According to the median time (7 days) of the first oral feeding after surgery, the patients were divided into early oral feeding group (EOF, feeding within 7 days after surgery, 67 cases) and late oral feeding group (LOF, feeding after 7 days, 54 cases). Postoperative blood glucose level, incidence of complications, nutritional and immune indexes, inflammatory indexes, normalized T12-SMA (the postoperative/preoperative ratio of vertical spinal muscle cross-sectional area at the 12th thoracic vertebra level) and QLQ-C30 (Quality Of Life Questionnaire) scores were recorded and compared in the two groups.ResultsThere was no statistical difference in preoperative nutritional index and postoperative complication rates between the EOF and LOF group (p > 0.05). The postoperative nutritional index (ALB, PA, TRF, Hb) and immune index (IgA, IgG, IgM) of the EOF group were higher than those of the LOF group (p < 0.05), and the inflammatory indicators (CRP, IL-6) of the EOF group were significantly lower than those of the LOF group (p < 0.05). Moreover, postoperative T12-SMA variation and QLQ-C30 scores of the EOF group were higher than those in LOF group (p < 0.05).ConclusionsEarly oral feeding is safe and feasible for patients with type II diabetes after radical resection of esophageal cancer, and it can improve short-term nutritional status and postoperative life quality of the patients.
Highlights
Esophageal cancer is one of the most common digestive malignancies worldwide, with morbidity and mortality rank the 7th and 6th among all malignancies, respectively
For patients of esophageal cancer accompanied with type II diabetes, postoperative complications such as difficult incision healing, pulmonary infection and anastomotic fistula are more likely to occur, which remarkably increases the risk of complications after surgery [7,8,9]
According to the median time (7 days) of the first oral feeding after surgery, the patients were divided into early oral feeding group (EOF, feeding within 7 days after surgery, 67 cases) and late oral feeding group (LOF, feeding after 7 days, 54 cases)
Summary
Esophageal cancer is one of the most common digestive malignancies worldwide, with morbidity and mortality rank the 7th and 6th among all malignancies, respectively. GLOBOCAN data showed that 572,000 new cases of esophageal cancer and 509,000 deaths were reported in 2018 over the worldwide [1]. The number of new cases and deaths of esophageal cancer in China ranks the first in the world, accounting for about 50% of the cases and deaths globally [2]. Surgical resection is the main treatment method for patients with esophageal cancer at present. It has been reported that diabetes may be an independent risk factor for the incidence of esophageal cancer [4]. For patients of esophageal cancer accompanied with type II diabetes, postoperative complications such as difficult incision healing, pulmonary infection and anastomotic fistula are more likely to occur, which remarkably increases the risk of complications after surgery [7,8,9]. It is of great significance to reduce the surgical risk of this group of patients
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