Presence and Persistence of Nutrition-Related Symptoms During the First Year Following Esophagectomy with Gastric Tube Reconstruction in Clinically Disease-Free Patients

• Published in: World journal of surgery Vol. 34; no. 12; pp. 2844 - 2852
• Main Authors: Haverkort, E. B., Binnekade, J. M., Busch, O. R. C., van Berge Henegouwen, M. I., de Haan, R. J., Gouma, D. J.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.12.2010; Springer‐Verlag; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Aged; Anastomosis, Surgical; Biological and medical sciences; Body Weight; Cardiac Surgery; Celiac Disease; Digestive System Diseases - etiology; Early Satiety; Enteral Nutrition; Esophageal Neoplasms - surgery; Esophagectomy - adverse effects; Female; General aspects; General Surgery; Humans; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic diseases; Middle Aged; Nutrition Disorders - etiology; Nutritional Status; Reconstructive Surgical Procedures - adverse effects; Stomach - surgery; Stomach, duodenum, intestine, rectum, anus; Stool Frequency; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surveys and Questionnaires; Thoracic Surgery; Tube Feeding; Vascular Surgery; Celiac Disease; Enteral Nutrition; Early Satiety; Tube Feeding; Stool Frequency; Human; Stomach; Tube; Disease; Nutrition; Digestive system; Free form; Esophagectomy; Patient; Anatomical reconstruction; Feeding; Esophagus; Medicine; Persistence; Symptomatology; Treatment; Diet; Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-010-0786-8

Background Esophagectomy with gastric tube reconstruction results in a variety of postoperative nutrition-related symptoms that may influence the patient’s nutritional status. Methods We developed a 15-item questionnaire, focusing on the nutrition-related complaints the first year after an esophagectomy. The questionnaire was filled out the first week after discharge and 3, 6, and 12 months after surgery. The use of enteral nutrition, meal size and frequency, social aspects related to eating, defecation pattern, and body weight were recorded at the same time points. We analyzed the relationship between the baseline characteristics and the number of nutrition-related symptoms, as well as the relationship between those symptoms and body weight with linear mixed models. Results We found no significant within-patient change for the total number of nutrition-related symptoms ( P  = 0.67). None of the baseline factors were identified as predictors of the complaint scores. The most frequently experienced complaints were early satiety, postprandial dumping syndrome, inhibited passage due to high viscosity, reflux, and absence of hunger. One year after surgery, meal sizes were still smaller, the social aspects of eating were influenced negatively, and patients experienced an altered stool frequency. Directly after the surgical procedure 78% of the patients lost weight, and the entire postoperative year the mean body weight remained lower ( P  = 0.47). We observed no association between the complaint scores and body weight ( P  = 0.15). Conclusions After an esophagectomy, most patients struggle with nutrition-related symptoms, are confronted with nutrition-related adjustments and a reduced body weight.