The application of a medium-chain fatty diet and enteral nutrition in post-operative chylous leakage: analysis of 63 patients
BackgroundPost-operative chylous leakage (CL) is the pathologic leakage of chylomicron fluid after surgery. This retrospective study was performed to evaluate a uniform oral nutrition management strategy on the post-operative CL.MethodsWe retrospectively reviewed patients who developed post-operativ...
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2023.1128864/full |
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| author | Ke Wang Jiaming Xiao Li Li Xu Li Yilun Yang Zhiyu Liu Jing Jiang |
| author_facet | Ke Wang Jiaming Xiao Li Li Xu Li Yilun Yang Zhiyu Liu Jing Jiang |
| author_sort | Ke Wang |
| collection | DOAJ |
| description | BackgroundPost-operative chylous leakage (CL) is the pathologic leakage of chylomicron fluid after surgery. This retrospective study was performed to evaluate a uniform oral nutrition management strategy on the post-operative CL.MethodsWe retrospectively reviewed patients who developed post-operative CL and received consultation from a clinical nutritionist in seven departments of the Second Affiliated Hospital of Dalian Medical University from May 2020 to April 2022. We designed the oral nutrition intervention program which mainly standardized the type and amount of foods contained in the medium-chain triglyceride (MCT) diet. The influencing factors of curative efficacy were analyzed. Finally, binary logistic regression analysis was conducted to observe the relationship between curative efficacy and potentially predictive variables, including post-operative albumin, post-operative hemoglobin, surgical procedure, and drainage volume at consultation.ResultsSixty-three patients with post-operative CL were included in this analysis. Of this number, 58 patients were cured successfully without other treatments. Three patients had a significantly prolonged recovery period, and the remaining two cases were treated by reoperation therapy. The leakage volume at the initiation of enteral intervention had no statistically significant difference in seven surgical departments and surgical sites (left, right, median, and bilateral). The length of stay (LOS) of patients with CL after the intervention was not significantly increased in cardiac, hepatobiliary, gastrointestinal, and urological surgeries. Patients with CL had longer LOS than those without CL in gynecology (P=0.044) and thyroid surgery departments (P=0.008). Each unit increase in post-operative hemoglobin would increase the probability of an effective outcome by 8%, which was statistically significant (P = 0.037).ConclusionIn treating patients with post-operative CL, we recommend the MCT diet and EN as the first option, rather than fasting, parenteral nutrition (PN), or octreotide. |
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| series | Frontiers in Nutrition |
| spelling | doaj.art-2905307af4464e379a59104379a8c8812023-07-20T19:11:57ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2023-07-011010.3389/fnut.2023.11288641128864The application of a medium-chain fatty diet and enteral nutrition in post-operative chylous leakage: analysis of 63 patientsKe Wang0Jiaming Xiao1Li Li2Xu Li3Yilun Yang4Zhiyu Liu5Jing Jiang6Department of Clinical Nutrition, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, ChinaDepartment of Nutrition and Food Hygiene, School of Public Health, Dalian Medical University, Dalian, Liaoning, ChinaDepartment of Clinical Nutrition, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, ChinaDepartment of Clinical Nutrition, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, ChinaDepartment of Clinical Nutrition, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, ChinaDepartment of Urological Surgery, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, ChinaDepartment of Nursing, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, ChinaBackgroundPost-operative chylous leakage (CL) is the pathologic leakage of chylomicron fluid after surgery. This retrospective study was performed to evaluate a uniform oral nutrition management strategy on the post-operative CL.MethodsWe retrospectively reviewed patients who developed post-operative CL and received consultation from a clinical nutritionist in seven departments of the Second Affiliated Hospital of Dalian Medical University from May 2020 to April 2022. We designed the oral nutrition intervention program which mainly standardized the type and amount of foods contained in the medium-chain triglyceride (MCT) diet. The influencing factors of curative efficacy were analyzed. Finally, binary logistic regression analysis was conducted to observe the relationship between curative efficacy and potentially predictive variables, including post-operative albumin, post-operative hemoglobin, surgical procedure, and drainage volume at consultation.ResultsSixty-three patients with post-operative CL were included in this analysis. Of this number, 58 patients were cured successfully without other treatments. Three patients had a significantly prolonged recovery period, and the remaining two cases were treated by reoperation therapy. The leakage volume at the initiation of enteral intervention had no statistically significant difference in seven surgical departments and surgical sites (left, right, median, and bilateral). The length of stay (LOS) of patients with CL after the intervention was not significantly increased in cardiac, hepatobiliary, gastrointestinal, and urological surgeries. Patients with CL had longer LOS than those without CL in gynecology (P=0.044) and thyroid surgery departments (P=0.008). Each unit increase in post-operative hemoglobin would increase the probability of an effective outcome by 8%, which was statistically significant (P = 0.037).ConclusionIn treating patients with post-operative CL, we recommend the MCT diet and EN as the first option, rather than fasting, parenteral nutrition (PN), or octreotide.https://www.frontiersin.org/articles/10.3389/fnut.2023.1128864/fullchylous leakagenutritional interventionmedium-chain fatty dietenteral nutritionpost-operation |
| spellingShingle | Ke Wang Jiaming Xiao Li Li Xu Li Yilun Yang Zhiyu Liu Jing Jiang The application of a medium-chain fatty diet and enteral nutrition in post-operative chylous leakage: analysis of 63 patients Frontiers in Nutrition chylous leakage nutritional intervention medium-chain fatty diet enteral nutrition post-operation |
| title | The application of a medium-chain fatty diet and enteral nutrition in post-operative chylous leakage: analysis of 63 patients |
| title_full | The application of a medium-chain fatty diet and enteral nutrition in post-operative chylous leakage: analysis of 63 patients |
| title_fullStr | The application of a medium-chain fatty diet and enteral nutrition in post-operative chylous leakage: analysis of 63 patients |
| title_full_unstemmed | The application of a medium-chain fatty diet and enteral nutrition in post-operative chylous leakage: analysis of 63 patients |
| title_short | The application of a medium-chain fatty diet and enteral nutrition in post-operative chylous leakage: analysis of 63 patients |
| title_sort | application of a medium chain fatty diet and enteral nutrition in post operative chylous leakage analysis of 63 patients |
| topic | chylous leakage nutritional intervention medium-chain fatty diet enteral nutrition post-operation |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2023.1128864/full |
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