Research progress on prevention and management of postoperative enteral nutrition intolerance in patients with gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YE Peiling ¹ , YUAN Xingzhu ¹ , LIU Changqing ² ,  LI Ka ¹

1. West China School of Nursing, Sichuan University / West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Anesthesiology, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

LI Ka, Email: lika127@126.com

Keywords：

gastric cancer; nutrition support; enteral nutrition; nutritional intolerance

DOI：

10.7507/1007-9424.202408080

Video：

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Objective To summarize the existing prevention and treatment methods for postoperative enteral nutrition intolerance in patients with gastric cancer, so as to provide reference for clinical health care providers. Method The related literatures on the factors affecting and the prevention and treatment measures for postoperative enteral nutrition intolerance in Chinese and English databases were systematically searched, and summarized. Results The occurrence of enteral nutrition intolerance after gastric cancer surgery was the result of the interaction of multiple factors. Currently, the prevention and treatment measures of enteral nutrition intolerance covered various aspects, including traditional Chinese medicine therapies such as moxibustion and massage, optimizing the nutritional formula to improve tolerance, adjusting the enteral nutrition infusion methods to reduce adverse reactions, and strategies such as enteral nutrition preconditioning. However, the effectiveness of some measures still required further validation. Conclusions At present, a series of measures have been taken in clinic for enteral nutrition intolerance, and some results have been achieved. In the future, we should strengthen the identification of people at risk of enteral nutrition intolerance to prevent the occurrence of enteral nutrition intolerance. At the same time, a scientific enteral nutrition scheme is formulated to ensure the implementation effect of enteral nutrition and promote the prognosis of patients.

Citation： YE Peiling, YUAN Xingzhu, LIU Changqing, LI Ka. Research progress on prevention and management of postoperative enteral nutrition intolerance in patients with gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(12): 1522-1527. doi: 10.7507/1007-9424.202408080 Copy

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1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. 鄭榮壽, 陳茹, 韓冰峰, 等. 2022年中國惡性腫瘤流行情況分析. 中華腫瘤雜志, 2024, 46(3): 221-231.
3. 姚一菲, 孫可欣, 鄭榮壽. 《2022全球癌癥統計報告》解讀: 中國與全球對比. 中國普外基礎與臨床雜志, 2024, 31(07): 769-780.
4. 李茁鈺, 劉凱, 張維漢, 等. 全球及中國胃癌的流行病學特點及趨勢: 2018–2022《全球癌癥統計報告》解讀. 中國普外基礎與臨床雜志, 2024, 31(10): 1236-1245.
5. 國家衛生健康委員會. 胃癌診療規范(2018年版). 中華消化病與影像雜志(電子版), 2019, 9(3): 118-144.
6. 杜雨家, 史業東, 孫小杰. 胃癌患者術后早期腸內營養不耐受的發生情況及其相關影響因素分析. 中華臨床營養雜志, 2021, 29(6): 373-377.
7. 中國抗癌協會腫瘤營養專業委員會, 中華醫學會腸外腸內營養學分會. 胃癌患者的營養治療專家共識. 腫瘤代謝與營養電子雜志, 2023, 10(2): 208-212.
8. Rinninella E, Cintoni M, Raoul P, et al. Effects of nutritional interventions on nutritional status in patients with gastric cancer: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr ESPEN, 2020, 38: 28-42.
9. Yan X, Zhou FX, Lan T, et al. Optimal postoperative nutrition support for patients with gastrointestinal malignancy: A systematic review and meta-analysis. Clin Nutr, 2017, 36(3): 710-721.
10. Pimiento JM, Evans DC, Tyler R, et al. Value of nutrition support therapy in patients with gastrointestinal malignancies: a narrative review and health economic analysis of impact on clinical outcomes in the United States. J Gastrointest Oncol, 2021, 12(2): 864-873.
11. Muscaritoli M, Arends J, Bachmann P, et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr, 2021, 40(5): 2898-2913.
12. Reintam Blaser A, Starkopf L, Deane AM, et al. Comparison of different definitions of feeding intolerance: A retrospective observational study. Clin Nutr, 2015, 34(5): 956-961.
13. Wu XY, Li XZ, Yu DL, et al. Construction of a model predicting the risk of tube feeding intolerance after gastrectomy for gastric cancer based on 225 cases from a single Chinese center. Oncotarget, 2017, 8(59): 99940-99949.
14. 周飛燕. 胃癌患者術后早期腸內營養喂養不足的調查分析及干預研究. 南京醫科大學, 2012.
15. Song J, Zhou C, Zhang T. Prognostic factors associated with gastrointestinal dysfunction after gastrointestinal tumor surgery: A meta-analysis. World J Gastrointest Surg, 2024, 16(5): 1420-1429.
16. Zheng H, Zhang C, Wang Q, et al. The impact of aging on intestinal mucosal immune function and clinical applications. Front Immunol, 2022, 131029948. doi: 10.3389/fimmu.2022.1029948.
17. Bhutto A, Morley JE. The clinical significance of gastrointestinal changes with aging. Curr Opin Clin Nutr Metab Care, 2008, 11(5): 651-660.
18. Zhong Y, Cao Z, Baumer D, et al. Incidence and risk factors for postoperative gastrointestinal dysfunction occurrence after gastrointestinal procedures in US patients. Am J Surg, 2023, 226(5): 675-681.
19. Reintam Blaser A, Jakob SM, Starkopf J. Gastrointestinal failure in the ICU. Curr Opin Crit Care, 2016, 22(2): 128-141.
20. Jang A, Jeong O. Tolerability of early oral nutrition and factors predicting early oral nutrition failure after gastrectomy. Clin Nutr, 2020, 39(11): 3331-3336.
21. Di Donna MC, Cucinella G, Giallombardo V, et al. Urinary, gastrointestinal, and sexual dysfunctions after chemotherapy, radiotherapy, radical surgery or multimodal treatment in women with locally advanced cervical cancer: a multicenter retrospective study. Cancers (Basel), 2023, 15(24): 5734. doi: 10.3390/cancers15245734.
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Research progress on prevention and management of postoperative enteral nutrition intolerance in patients with gastric cancer

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