Usefulness of Perioperative Nutritional Therapy with the Glutamine/Arginine/Calcium β-Hydroxy-β-Methylbutyrate Product in Esophageal Cancer Surgery: A Single-Center Retrospective Study

• Published in: Nutrients 2024-07, Vol.16 (13), p.2126
• Main Authors: Okamoto, Koichi, Takamura, Hiroyuki, Nagayama, Taigo, Sannomiya, Yuta, Hashimoto, Akifumi, Nishiki, Hisashi, Kaida, Daisuke, Miyata, Takashi, Tsuji, Toshikatsu, Fujita, Hideto, Kinami, Shinichi, Ninomiya, Itasu, Inaki, Noriyuki
• Format: Article
• Language: English
• Subjects: Abdomen; Aged; Amino acids; Arginine - administration & dosage; Blood; Body mass index; Calcium; Cancer surgery; Cancer therapies; Care and treatment; complication; Complications and side effects; Diagnosis; Dissection; Enteral nutrition; Esophageal cancer; Esophageal Neoplasms - surgery; Esophagectomy; Female; Gastrointestinal surgery; Glutamine - administration & dosage; Humans; Lymphatic system; Male; Malnutrition; Medical nutrition therapy; Middle Aged; minimally invasive esophagectomy; Muscle, Skeletal - drug effects; Nutrition therapy; Nutrition Therapy - methods; Nutritional Status; Ostomy; Patient outcomes; Perioperative Care - methods; Postoperative Complications - prevention & control; Recovery (Medical); Retrospective Studies; Risk factors; Sarcopenia; Spinal manipulation; Treatment Outcome; Valerates - administration & dosage
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu16132126

A useful perioperative nutritional therapy for highly invasive esophageal cancer surgical cases needs to be developed. We clarified the usefulness of amino-acid-enriched nutritional therapy using glutamine (Gln)/arginine (Arg)/calcium β-hydroxy-β-methylbutyrate (HMB) products on the short-term postoperative outcomes of minimally invasive esophagectomy for esophageal cancer. Altogether, 114 patients (Gln/Arg/HMB group) received perioperative nutritional therapy with Gln/Arg/HMB products, and we retrospectively investigated the change in nutritional parameters including skeletal muscle mass, occurrence of postoperative complications, and short-term postoperative outcomes in this group. The results were compared between the Gln/Arg/HMB and control groups (79 patients not receiving the Gln/Arg/HMB products). The incidence of all postoperative complications, sputum expectoration disorder, and pleural effusion of grade ≥ III was significantly lower in the Gln/Arg/HMB group (62.0% vs. 38.6%, = 0.001; 44.3% vs. 28.1%, = 0.020; 27.8% vs. 13.2%, = 0.011, respectively). The psoas muscle area and postoperative body weight were significantly higher at 1 month and 1 year after surgery in the Gln/Arg/HMB group than in the control group (93.5% vs. 99.9%, < 0.001; 92.0% vs. 95.4%, = 0.006). Perioperative amino-acid-enriched nutritional therapy may improve the short-term postoperative outcomes, nutritional status, and skeletal muscle mass of esophageal cancer surgical patients.