Suboptimal Intake of Nutrients after Esophagectomy with Gastric Tube Reconstruction


      Esophagectomy with gastric tube reconstruction results in a variety of postoperative nutrition-related complaints that can impair nutritional intake and nutritional status. The aim of this study was to determine to what extent patients reached the recommended intake of various nutrients at 6 and 12 months after esophagectomy. It was also analyzed whether a suboptimal intake could be explained by the most clinically significant nutrition-related complaints after esophagectomy. In a prospective cohort study (2002 to 2006), the nutrient intake of 96 patients, recorded in preprinted nutritional diaries, was compared with the recommended energy intake in The Netherlands and Recommended Dietary Allowance of protein and micronutrients. Energy and protein intake remained below recommendations in 24% and 7% of the patients, respectively. Less than 10% of the patients had a sufficient intake of all micronutrients. Folic acid, vitamin D, copper, calcium, and vitamin B-1 were the micronutrients most often reported to have a suboptimal intake. Multivariate logistic regression, corrected for preoperative epigastric pain and energy intake, showed that the number of nutrition-related complaints was not an independent risk factor for the presence of a suboptimal intake of nutrients (adjusted odds ratio=1.11; 95% CI: 0.94 to 1.31; P = 0.22). This study shows that the intake of micronutrients remains below recommendations in the majority of patients 12 months after esophagectomy. This problem requires special attention and care by registered dietitians.


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      E. B. Haverkort is a research dietitian, Department of Dietetics, The Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.


      J. M. Binnekade is a research nurse, Department of Intensive Care, The Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.


      R. J. de Haan is a professor, Clinical Research Unit, The Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.


      O. R. C. Busch is a professor, Department of Surgery, The Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.


      D. J. Gouma is a professor, Department of Surgery, The Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.


      M. I. van Berge Henegouwen is a surgeon, Department of Surgery, The Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.