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在癌症开放性胰腺切除术的增强康复计划中补充腹腔营养:实用,多中心,随机对照试验
Luca Gianotti1, Salvatore Paiella2,3, Giovanni Capretti4,5
1School of Medicine and Surgery, Milano-Bicocca University, Pancreas Surgery Unit, IRCCS San Gerardo, Monza, Italy.
EClinicalMedicine
|September 2, 2025
概括
在强化康复计划中,补充腹腔营养 (SPN) 没有减少胰腺切除术 (PD) 后的并发症. 在这组患者中,早期口服养与SPN一样有效.
科学领域:
- 外科瘤学
- 胃肠病学
- 临床营养
背景情况:
- 在手术后增强恢复 (ERAS) 计划中,补充肠道营养 (SPN) 在胰腺切除术 (PD) 后的作用尚不清楚.
- 这项研究调查了SPN是否与PD后的早期口服养相比改善了结果.
研究的目的:
- 为了确定补充性肠道营养 (SPN) 是否优于早期口服养,以减少胰腺切除术后的术后并发症.
主要方法:
- 一个实用,多中心,随机对照试验,涉及254名癌症开放性PD患者.
- 患者在ERAS计划中获得SPN (1-5天) 或没有SPN,同时获得早期口服养.
- 主要结论是术后90天的综合并发症指数 (CCI) 评估的病情负担.
主要成果:
- 在SPN和无SPN组之间,中位数CCI (20. 9 vs. 20. 9) 或并发症患者比例 (29. 6% vs.
- 总体上90天的发病率相似:没有SPN组的67. 4%,SPN组的63. 2%.
- 在高营养风险患者中,SPN没有显示出保护作用.
结论:
- 在ERAS计划中,当允许早期口服养时,补充性肠道营养 (SPN) 不会改善胰腺切除术 (PD) 后的结果.
- 这些发现表明,在标准的ERAS方案中,SPN对于接受PD的患者是不必要的,但严重营养不良的患者除外.
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