Clinical efficacy of carbohydrate preloading in reconstructive esophageal surgery

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OBJECTIVE

To evaluate clinical efficacy of preoperative carbohydrate loading as a component of ERAS in esophageal reconstructive surgery.

MATERIAL AND METHODS

Post hoc analysis included 162 patients who underwent esophageal reconstructive interventions with ERAS principles between 2014 and 2024. The main group (n=61, CHO+) included patients who were metabolically loaded with carbohydrates in preoperative period with 12.5% maltodextrin solution 800 mL the day before and 400 mL 2 hours before surgery per os or enterally. The control group consisted of patients without carbohydrate load (n=101, CHO–). Primary endpoint was length of hospital-stay, secondary control points — postoperative glycemia and complication rate.

RESULTS

Both groups were comparable in sex, age, character of the main and comorbid diseases, body mass index. Patients with CHO had significant lower incidence of respiratory complications (p=0.034). Both groups did not differ in the incidence of anastomosis failure, morbidity and mortality.

CONCLUSION

Preoperative carbohydrate loading in esophageal reconstructive surgery positively affects metabolic status and reduces the incidence of respiratory complications without effect on length of hospital-stay.

Keywords:

carbohydrate preload

metabolic status

esophageal repair

enhanced recovery after surgery

Authors:

Tarasova I.A.

Petrovsky National Research Centre of Surgery;
Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0001-9344-7351

Tshkovrebov A.T.

Petrovsky National Research Centre of Surgery

ORCID: 0000-0002-4445-2530

Bitarov T.T.

Petrovsky National Research Centre of Surgery

ORCID: 0000-0002-0484-5022

Boeva I.A.

Petrovsky National Research Centre of Surgery

ORCID: 0000-0003-2646-0729

Ivanova M.Yu.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0001-9917-6230

Shestakov A.L.

Petrovsky National Research Centre of Surgery;
Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0001-7061-6298

Received:

14.08.2024

Accepted:

03.09.2024

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