在胃食道癌症手术后,脂肪吸收不良和胰腺外分功能降低
L Blonk1, N J Wierdsma2, H Hamer3
1Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Surgery, De Boelelaan, 1117, Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Nutrition and Dietetics, De Boelelaan 1117, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands.
概括
胃食道手术后脂肪吸收不良很常见,影响到43%的患者. 可以考虑胰腺酶替代疗法 (PERT),但需要进一步研究.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 营养科学 营养科学
背景情况:
- 胃食道癌手术患者经常表现出吸收不良的症状.
- 胰腺酶替代疗法 (PERT) 经常在经验上使用.
- 手术后需要对吸收不良和胰腺功能的客观评估.
研究的目的:
- 在胃食道手术后的患者中量化脂肪吸收不良.
- 评估这些患者的异位胰腺功能.
- 为了将手术重建类型与吸收不良和胰腺功能相关联.
主要方法:
- 包括90名患者6个月以上的食道切除或胃切除 (2017-2021年).
- 在研究之前停止了PERT.
- 通过便脂肪平衡试验测量脂肪吸收不良 (脂肪吸收系数,CFA <85%) 和通过便弹性酶-1 (FE-1) 测量异位胰腺功能.
主要成果:
- 脂肪吸收不良 (CFA <85%) 在胃管重建后观察到24%,在Roux-en-Y重建后观察到43%.
- 降低的FE-1水平伴随着 33% (胃管) 和 70% (Roux-en-Y) 的吸收不良.
- 在Roux-en-Y重建后,吸收不良更为普遍.
结论:
- 脂肪吸收不良是胃食道癌症手术后的一个重要问题,特别是在Roux-en-Y重建后.
- 减少的外分胰腺功能 (低FE-1) 经常与这种吸收不良有关.
- 建议对吸收不良进行临床警,并可能考虑PERT等待进一步研究.
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