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Effect of early oral nutrition supplement using Encover in patients undergoing hepato-biliary-pancreatic surgery

  • Byeong Jun Lee (Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Joon Seong Park (Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Hyung Sun Kim (Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Dong Sup Yoon (Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Jin Hong Lim (Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • Received : 2021.10.28
  • Accepted : 2021.11.17
  • Published : 2022.08.31

Abstract

Backgrounds/Aims: Early recovery after surgery has become a popular trend. The aim of this study was to evaluate effect of nutritional intervention using Encover, an oral nutritional supplement, in patients undergoing hepato-biliary-pancreatic surgery. Methods: This single center, prospective case-control study was conducted in Gangnam Severance Hospital from September 2018 to April 2019. Through randomization, patients were divided into an experimental group (30 patients) and a control group (30 patients). At postoperative seven days, the experimental group was instructed to take two packs of Encover (JW Pharmaceutical, Seoul, Korea) daily for seven days. Body cell mass index was measured at seven days after surgery and 14 days after discharge and Patient-Generated Subjective Global Assessment (PG-SGA) was performed at 14 days after discharge. Results: Body cell mass index during outpatient follow-up was significantly decreased compared to that at discharge in both groups. However, the amount of body cell mass index showed no significant difference between postoperative seven days and outpatient follow-up in either group. During outpatient follow-up, the experimental group had a higher mean value of PG-SGA score than the control group (11.32 ± 3.46 vs. 9.48 ± 3.97; p = 0.037). Conclusions: Short-term Encover doses after surgery may not produce significant results in weight gain or other body cell mass index. Encover did not significantly affect other dietary conditions based on PG-SGA.

Keywords

Acknowledgement

This study was an investigator-initiated trial supported by JW pharmaceutical.

References

  1. Bistrian BR, Blackburn GL, Hallowell E, Heddle R. Protein status of general surgical patients. JAMA 1974;230:858-860. https://doi.org/10.1001/jama.1974.03240060028025
  2. Kondrup J, Johansen N, Plum LM, Bak L, Larsen IH, Martinsen A, et al. Incidence of nutritional risk and causes of inadequate nutritional care in hospitals. Clin Nutr 2002;21:461-468. https://doi.org/10.1054/clnu.2002.0585
  3. Norman K, Pichard C, Lochs H, Pirlich M. Prognostic impact of disease-related malnutrition. Clin Nutr 2008;27:5-15. https://doi.org/10.1016/j.clnu.2007.10.007
  4. Yu YD, Han JH, Jung SW, Kim DS. Safety and efficacy of peripheral nutrition fluid (MG-TNA®) in patients undergoing surgery for hepatobiliary and pancreatic disease: results of a phase 4 trial. Ann Hepatobiliary Pancreat Surg 2019;23:133-137. https://doi.org/10.14701/ahbps.2019.23.2.133
  5. Nanashima A, Hiyoshi M, Imamura N, Yano K, Hamada T, Hamada R, et al. Clinical significance of preoperative nutritional parameter and patient outcomes after pancreatectomy: a retrospective study at two academic institute. Ann Hepatobiliary Pancreat Surg 2019;23:168-173. https://doi.org/10.14701/ahbps.2019.23.2.168
  6. Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 2003;22:235-239. https://doi.org/10.1016/S0261-5614(02)00215-7
  7. Schricker T, Wykes L, Eberhart L, Carli F, Meterissian S. Randomized clinical trial of the anabolic effect of hypocaloric parenteral nutrition after abdominal surgery. Br J Surg 2005;92:947-953. https://doi.org/10.1002/bjs.5105
  8. Shin SH, Kang WH, Han IW, You Y, Lee H, Kim H, et al. National survey of Korean hepatobiliary-pancreatic surgeons on attitudes about the enhanced recovery after surgery protocol. Ann Hepatobiliary Pancreat Surg 2020;24:477-483. https://doi.org/10.14701/ahbps.2020.24.4.477
  9. Fung AKY, Chong CCN, Lai PBS. ERAS in minimally invasive hepatectomy. Ann Hepatobiliary Pancreat Surg 2020;24:119-126. https://doi.org/10.14701/ahbps.2020.24.2.119
  10. Cavallaro P, Bordeianou L. Implementation of an ERAS pathway in colorectal surgery. Clin Colon Rectal Surg 2019;32:102-108. https://doi.org/10.1055/s-0038-1676474
  11. Zaghiyan K, Felder S, Ovsepyan G, Murrell Z, Sokol T, Moore B, et al. A prospective randomized controlled trial of sugared chewing gum on gastrointestinal recovery after major colorectal surgery in patients managed with early enteral feeding. Dis Colon Rectum 2013;56:328-335. https://doi.org/10.1097/DCR.0b013e31827e4971
  12. Tanaka M. Gastroparesis after a pylorus-preserving pancreatoduodenectomy. Surg Today 2005;35:345-350. https://doi.org/10.1007/s00595-004-2961-8
  13. Kang Y, Park S, Kim S, Kim SY, Koh H. Therapeutic efficacy of exclusive enteral nutrition with specific polymeric diet in pediatric Crohn's disease. Pediatr Gastroenterol Hepatol Nutr 2019;22:72-79. https://doi.org/10.5223/pghn.2019.22.1.72
  14. Kong SH, Park JS, Lee IK, Ryu SW, Park YK, Yang HK, et al. Postoperative oral nutritional supplementation after major gastrointestinal surgery: a randomized controlled clinical trial. Asia Pac J Clin Nutr 2017;26:811-819.
  15. Okamura Y, Maeda A, Matsunaga K, Kanemoto H, Uesaka K. Negative impact of low body mass index on surgical outcomes after hepatectomy for hepatocellular carcinoma. J Hepatobiliary Pancreat Sci 2012;19:449-457. https://doi.org/10.1007/s00534-011-0461-y
  16. Kim SH, Shon JY, Park JS, Kim JW, Kang JH, Yun EY, et al. Change in dietary intake and nutritional status using Mealworms as hospital meal in postoperative patients. J Korean Diet Assoc 2016;22:292-309. https://doi.org/10.14373/JKDA.2016.22.4.292
  17. Salacinski AJ, Howell SM, Hill DL. Validity of the InBody 520TM to predict metabolic rate in apparently healthy adults. J Sports Med Phys Fitness 2018;58:1275-1280.
  18. Ogawa H, Fujitani K, Tsujinaka T, Imanishi K, Shirakata H, Kantani A, et al. InBody 720 as a new method of evaluating visceral obesity. Hepatogastroenterology 2011;58:42-44.
  19. Ntineri A, Prapa S, Bountzona I, Menti A, Stergiou GS. Validation of the single-cuff oscillometric blood pressure monitor InBody BPBIO750 for public spaces according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization Universal Standard. Blood Press Monit 2021;26:146-148. https://doi.org/10.1097/MBP.0000000000000507
  20. De Groot LM, Lee G, Ackerie A, van der Meij BS. Malnutrition screening and assessment in the cancer care ambulatory setting: mortality predictability and validity of the Patient-Generated Subjective Global Assessment Short form (PG-SGA SF) and the GLIM criteria. Nutrients 2020;12:2287.
  21. Nitichai N, Angkatavanich J, Somlaw N, Voravud N, Lertbutsayanukul C. Validation of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) in Thai setting and association with nutritional parameters in cancer patients. Asian Pac J Cancer Prev 2019;20:1249-1255. https://doi.org/10.31557/APJCP.2019.20.4.1249
  22. Wiegert EVM, Padilha PC, Peres WAF. Performance of Patient-Generated Subjective Global Assessment (PG-SGA) in patients with advanced cancer in palliative care. Nutr Clin Pract 2017;32:675-681. https://doi.org/10.1177/0884533617725071
  23. Du H, Liu B, Xie Y, Liu J, Wei Y, Hu H, et al. Comparison of different methods for nutrition assessment in patients with tumors. Oncol Lett 2017;14:165-170. https://doi.org/10.3892/ol.2017.6154
  24. Zhang YH, Xie FY, Chen YW, Wang HX, Tian WX, Sun WG, et al. Evaluating the nutritional status of oncology patients and its association with quality of life. Biomed Environ Sci 2018;31:637-644.
  25. You JW, Lee SJ, Kim YE, Cho YJ, Jeong YY, Kim HC, et al. Association between weight change and clinical outcomes in critically ill patients. J Crit Care 2013;28:923-927. https://doi.org/10.1016/j.jcrc.2013.07.055
  26. Ghorabi S, Ardehali H, Amiri Z, Vahdat Shariatpanahi Z. Association of the adductor pollicis muscle thickness with clinical outcomes in intensive care unit patients. Nutr Clin Pract 2016;31:523-526. https://doi.org/10.1177/0884533615621547
  27. A l lison SP. Ma lnutrition, disease, and outcome. Nutrition 2000;16:590-593.  https://doi.org/10.1016/S0899-9007(00)00368-3