Safety analysis of early oral feeding after esophagectomy in patients complicated with diabetes

J Cardiothorac Surg. 2021 Mar 26;16(1):56. doi: 10.1186/s13019-021-01410-4.

Abstract

Objective: To evaluate the safety of early oral feeding in patients with type II diabetes after radical resection of esophageal carcinoma.

Methods: The 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.

Results: There 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).

Conclusions: Early 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.

Keywords: Esophageal cancer; Life quality; Nutritional status; Oral feeding; Type II diabetes.

MeSH terms

  • Diabetes Mellitus, Type 2 / complications*
  • Esophageal Neoplasms / complications
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Period
  • Quality of Life*
  • Retrospective Studies