Nutritional Management of the Patients with Advanced Esophageal Cancer during Preoperative Combined Therapy

Abstract

Nutritional maintenance and postoperative pulmonary complications were retrospectively studied in 92 patients with advanced esophageal cancer who had received nutritional support during preoperative combined therapy. Hyperalimentation by either elemental diet or intravenous hyperalimentation to these patients resulted in generally good preoperative nutritional parameters, and the increase in rapid turnover serum proteins suggested improvement of preoperative nutrition. It was suggested on the basis of changes in body weight and serum protein that preoperative nutritional support should be at least 35 NPkcal/kg/day, a level that was also useful for recovery from the temporary immunosupression caused by irradiation. But serum albumin tended to decrease with any method or amount of nutritional support. Moreover, the serum albumin level of elderly patients over 70 years dropped lower than that of patients under 69 years. The incidence of postoperative pulmonary complications in the elderly patients was greater (p<0.05) than that in the younger patients if their final preoperative serum albumin level did not reach 3.5 g/dl. These results suggested that the nutritional management of elderly patients with advanced esophageal cancer should be examined more precisely to clarify more effective nutritional support.