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Supportive Care in Cancer

, Volume 26, Issue 6, pp 2057–2062 | Cite as

An investigation into the nutritional status of patients receiving an Enhanced Recovery After Surgery (ERAS) protocol versus standard care following Oesophagectomy

  • Katie BentonEmail author
  • Iain Thomson
  • Elisabeth Isenring
  • B. Mark Smithers
  • Ekta Agarwal
Original Article

Abstract

Purpose

Enhanced Recovery After Surgery (ERAS) protocols have been effectively expanded to various surgical specialities including oesophagectomy. Despite nutrition being a key component, actual nutrition outcomes and specific guidelines are lacking. This cohort comparison study aims to compare nutritional status and adherence during implementation of a standardised post-operative nutritional support protocol, as part of ERAS, compared to those who received usual care.

Methods

Two groups of patients undergoing resection of oesophageal cancer were studied. Group 1 (n = 17) underwent oesophagectomy between Oct 2014 and Nov 2016 during implementation of an ERAS protocol. Patients in group 2 (n = 16) underwent oesophagectomy between Jan 2011 and Dec 2012 prior to the implementation of ERAS. Demographic, nutritional status, dietary intake and adherence data were collected. Ordinal data was analysed using independent t tests, and categorical data using chi-square tests.

Results

There was no significant difference in nutrition status, dietary intake or length of stay following implementation of an ERAS protocol. Malnutrition remained prevalent in both groups at day 42 post surgery (n = 10, 83% usual care; and n = 9, 60% ERAS). A significant difference was demonstrated in adherence with earlier initiation of oral free fluids (p <0.008), transition to soft diet (p <0.004) and continuation of jejunostomy feeds on discharge (p <0.000) for the ERAS group.

Conclusion

A standardised post-operative nutrition protocol, within an ERAS framework, results in earlier transition to oral intake; however, malnutrition remains prevalent post surgery. Further large-scale studies are warranted to examine individualised decision-making regarding nutrition support within an ERAS protocol.

Keywords

Oesophagectomy Enhanced recovery after surgery Nutrition Early oral feeding 

Notes

Funding source

The study received funding from Allied Health Professions Office of Queensland, Health Practitioner Research Grant Scheme (internal grant awarded by the principal investigator). The funding source was not involved in any element of the study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Katie Benton
    • 1
    Email author
  • Iain Thomson
    • 2
  • Elisabeth Isenring
    • 1
    • 3
  • B. Mark Smithers
    • 2
  • Ekta Agarwal
    • 1
    • 3
  1. 1.Department of Nutrition and Dietetics, Princess Alexandra HospitalWoolloongabbaAustralia
  2. 2.Discipline of Surgery, Upper GI and Soft Tissue Unit, Princess Alexandra HospitalUniversity of QueenslandWoolloongabbaAustralia
  3. 3.Faculty of Health Sciences and MedicineBond UniversityRobinaAustralia

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