Early oral feeding after esophagectomy accelerated gut function recovery by regulating brain-gut peptide secretion

The impact of early oral feeding after esophagectomy on brain-gut peptide secretion and gut function recovery has not been well investigated. This study aimed to fill this research gap. This study was based on a randomized clinical trial (ClinicalTrials.gov: NCT01998230). The patients in the early o...

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Veröffentlicht in:Surgery 2022-09, Vol.172 (3), p.919-925
Hauptverfasser: Chen, Xiankai, Wang, Peiyu, Leng, Changsen, Sun, Haibo, Liu, Xianben, Zhang, Ruixiang, Qin, Jianjun, Hua, Xionghuai, Yu, Yongkui, Li, Haomiao, Zhang, Jun, Wu, Zhao, Li, Yin
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container_end_page 925
container_issue 3
container_start_page 919
container_title Surgery
container_volume 172
creator Chen, Xiankai
Wang, Peiyu
Leng, Changsen
Sun, Haibo
Liu, Xianben
Zhang, Ruixiang
Qin, Jianjun
Hua, Xionghuai
Yu, Yongkui
Li, Haomiao
Zhang, Jun
Wu, Zhao
Li, Yin
description The impact of early oral feeding after esophagectomy on brain-gut peptide secretion and gut function recovery has not been well investigated. This study aimed to fill this research gap. This study was based on a randomized clinical trial (ClinicalTrials.gov: NCT01998230). The patients in the early oral feeding group started oral food intake on postoperative day 1. In the late oral feeding group, nasogastric/nasoenteral feeding was applied from postoperative day 1 to 7, after which the patients began oral food intake. Serum brain-gut peptides were selected as the primary end points and tested before surgery and on postoperative days 1, 3, and 5. The time to first flatus and first defecation after surgery were evaluated. A total of 110 participants undergoing minimally invasive McKeown esophagectomy were prospectively included, with 63 patients in the early oral feeding group and 47 patients in the late oral feeding group. The distribution of clinicopathological characteristics was balanced between the 2 groups. Perioperative dynamic surveillance demonstrated higher serum concentrations of excitatory brain-gut peptides (gastrin P = .021, motilin P = .027, and substance-P P = .023) and lower serum concentrations of inhibitory brain-gut peptides (cholecystokinin P = .004 and somatostatin P = .019) in the early oral feeding group. Perioperative serum levels of brain-gut peptides correlated with postoperative early flatus and defecation. The multivariate analysis showed early oral feeding (versus late oral feeding) to be an independent predictive factor for early flatus and defecation (hazard ratio 2.40, P < .001; hazard ratio 2.73, P < .001, respectively). The early oral feeding program may accelerate the recovery of gut function by regulating brain-gut peptide secretion. Brain-gut peptides are possible treatment targets to improve early oral feeding benefits and promote personalized early oral feeding programs.
doi_str_mv 10.1016/j.surg.2022.04.041
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This study aimed to fill this research gap. This study was based on a randomized clinical trial (ClinicalTrials.gov: NCT01998230). The patients in the early oral feeding group started oral food intake on postoperative day 1. In the late oral feeding group, nasogastric/nasoenteral feeding was applied from postoperative day 1 to 7, after which the patients began oral food intake. Serum brain-gut peptides were selected as the primary end points and tested before surgery and on postoperative days 1, 3, and 5. The time to first flatus and first defecation after surgery were evaluated. A total of 110 participants undergoing minimally invasive McKeown esophagectomy were prospectively included, with 63 patients in the early oral feeding group and 47 patients in the late oral feeding group. The distribution of clinicopathological characteristics was balanced between the 2 groups. Perioperative dynamic surveillance demonstrated higher serum concentrations of excitatory brain-gut peptides (gastrin P = .021, motilin P = .027, and substance-P P = .023) and lower serum concentrations of inhibitory brain-gut peptides (cholecystokinin P = .004 and somatostatin P = .019) in the early oral feeding group. Perioperative serum levels of brain-gut peptides correlated with postoperative early flatus and defecation. The multivariate analysis showed early oral feeding (versus late oral feeding) to be an independent predictive factor for early flatus and defecation (hazard ratio 2.40, P &lt; .001; hazard ratio 2.73, P &lt; .001, respectively). The early oral feeding program may accelerate the recovery of gut function by regulating brain-gut peptide secretion. Brain-gut peptides are possible treatment targets to improve early oral feeding benefits and promote personalized early oral feeding programs.</description><identifier>ISSN: 0039-6060</identifier><identifier>EISSN: 1532-7361</identifier><identifier>DOI: 10.1016/j.surg.2022.04.041</identifier><language>eng</language><publisher>Elsevier Inc</publisher><ispartof>Surgery, 2022-09, Vol.172 (3), p.919-925</ispartof><rights>2022 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c333t-3809829c773a263cf61293385f800ea086a92a462319a239d53fbe4ecc665ac73</citedby><cites>FETCH-LOGICAL-c333t-3809829c773a263cf61293385f800ea086a92a462319a239d53fbe4ecc665ac73</cites><orcidid>0000-0002-7840-5548</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0039606022003063$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids></links><search><creatorcontrib>Chen, Xiankai</creatorcontrib><creatorcontrib>Wang, Peiyu</creatorcontrib><creatorcontrib>Leng, Changsen</creatorcontrib><creatorcontrib>Sun, Haibo</creatorcontrib><creatorcontrib>Liu, Xianben</creatorcontrib><creatorcontrib>Zhang, Ruixiang</creatorcontrib><creatorcontrib>Qin, Jianjun</creatorcontrib><creatorcontrib>Hua, Xionghuai</creatorcontrib><creatorcontrib>Yu, Yongkui</creatorcontrib><creatorcontrib>Li, Haomiao</creatorcontrib><creatorcontrib>Zhang, Jun</creatorcontrib><creatorcontrib>Wu, Zhao</creatorcontrib><creatorcontrib>Li, Yin</creatorcontrib><title>Early oral feeding after esophagectomy accelerated gut function recovery by regulating brain-gut peptide secretion</title><title>Surgery</title><description>The impact of early oral feeding after esophagectomy on brain-gut peptide secretion and gut function recovery has not been well investigated. 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Perioperative dynamic surveillance demonstrated higher serum concentrations of excitatory brain-gut peptides (gastrin P = .021, motilin P = .027, and substance-P P = .023) and lower serum concentrations of inhibitory brain-gut peptides (cholecystokinin P = .004 and somatostatin P = .019) in the early oral feeding group. Perioperative serum levels of brain-gut peptides correlated with postoperative early flatus and defecation. The multivariate analysis showed early oral feeding (versus late oral feeding) to be an independent predictive factor for early flatus and defecation (hazard ratio 2.40, P &lt; .001; hazard ratio 2.73, P &lt; .001, respectively). The early oral feeding program may accelerate the recovery of gut function by regulating brain-gut peptide secretion. 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This study aimed to fill this research gap. This study was based on a randomized clinical trial (ClinicalTrials.gov: NCT01998230). The patients in the early oral feeding group started oral food intake on postoperative day 1. In the late oral feeding group, nasogastric/nasoenteral feeding was applied from postoperative day 1 to 7, after which the patients began oral food intake. Serum brain-gut peptides were selected as the primary end points and tested before surgery and on postoperative days 1, 3, and 5. The time to first flatus and first defecation after surgery were evaluated. A total of 110 participants undergoing minimally invasive McKeown esophagectomy were prospectively included, with 63 patients in the early oral feeding group and 47 patients in the late oral feeding group. The distribution of clinicopathological characteristics was balanced between the 2 groups. Perioperative dynamic surveillance demonstrated higher serum concentrations of excitatory brain-gut peptides (gastrin P = .021, motilin P = .027, and substance-P P = .023) and lower serum concentrations of inhibitory brain-gut peptides (cholecystokinin P = .004 and somatostatin P = .019) in the early oral feeding group. Perioperative serum levels of brain-gut peptides correlated with postoperative early flatus and defecation. The multivariate analysis showed early oral feeding (versus late oral feeding) to be an independent predictive factor for early flatus and defecation (hazard ratio 2.40, P &lt; .001; hazard ratio 2.73, P &lt; .001, respectively). The early oral feeding program may accelerate the recovery of gut function by regulating brain-gut peptide secretion. Brain-gut peptides are possible treatment targets to improve early oral feeding benefits and promote personalized early oral feeding programs.</abstract><pub>Elsevier Inc</pub><doi>10.1016/j.surg.2022.04.041</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7840-5548</orcidid></addata></record>
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title Early oral feeding after esophagectomy accelerated gut function recovery by regulating brain-gut peptide secretion
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