P1.143. Effectiveness of 3-Months of Home Enteral Nutrition After Esophagectomy for Esophageal Cancer
TL;DR
In conclusion, nutritional supplementation during the 3 months after esophagectomy was associated with preservation of body weight and skeletal muscle mass, with total energy intake showing the strongest effect.
Abstract
Esophageal Cancer: Other After esophagectomy for esophageal cancer, postoperative weight loss and sarcopenia are common and associated with poor prognosis. Although enteral nutrition is recommended when oral intake is insufficient, the effectiveness and optimal duration of home enteral nutrition remain unclear. This retrospective single-center study included patients with thoracic esophageal cancer who underwent radical McKeown esophagectomy with gastric tube reconstruction and jejunostomy between March 2023 and December 2024. Patients with recorded body weight data preoperatively and at 3 months postoperatively were eligible. Enteral nutrition (EN) was initiated on postoperative day 1 and continued after discharge at a target of 600 kcal/day for 90 days. Nutritional counseling was provided monthly, and body composition was assessed using bioelectrical impedance analysis. Resting energy expenditure was calculated using the Schofield equation with an activity factor of 1.3. Patients were stratified based on EN/ONS intake (≥600 vs <600 kcal/day), oral intake (≥50% vs <50% of TEE), and total energy intake (≥75% vs <75% of TEE). Changes in body weight and skeletal muscle mass over 90 days were analyzed. Overall, 16 (41.0%) patients completed the 600 kcal/day target. They experienced significantly less weight loss at 3 months than the non-completion group (−7.6% vs −10.5%, p = 0.03). Oral intake sufficiency (≥ 50% of estimated energy requirements) was associated with a favorable trend in body weight and skeletal muscle mass changes. Achieving ≥ 75% of total energy expenditure was significantly associated with reduced weight (−7.9% vs −19.6%, p = 0.002) and muscle loss (−5.4% vs −12.3%, p = 0.01). In patients with insufficient oral intake, supplementation ≥ 600 kcal/day effectively reduced both weight and muscle loss. In conclusion, nutritional supplementation during the 3 months after esophagectomy was associated with preservation of body weight and skeletal muscle mass, with total energy intake showing the strongest effect. Supplementation of approximately 600 kcal/day was particularly beneficial for patients with insufficient oral intake. This structured approach incorporating nutritional counseling and BIA may provide a practical benchmark for postoperative nutritional management.