東華大學圖書館 |

Nutritional Status and Dysphagia in Patients with Oesophageal Cancer - the Impact of Oncological and Surgical Treatment.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Nutritional Status and Dysphagia in Patients with Oesophageal Cancer - the Impact of Oncological and Surgical Treatment./
作者:	Ericson, Jessica.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2021,
面頁冊數:	87 p.
附註:	Source: Dissertations Abstracts International, Volume: 83-03, Section: B.
Contained By:	Dissertations Abstracts International83-03B.
標題:	Metastasis. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28470392
ISBN:	9798744472511

Nutritional Status and Dysphagia in Patients with Oesophageal Cancer - the Impact of Oncological and Surgical Treatment.
Ericson, Jessica.

Nutritional Status and Dysphagia in Patients with Oesophageal Cancer - the Impact of Oncological and Surgical Treatment. - Ann Arbor : ProQuest Dissertations & Theses, 2021 - 87 p.

Source: Dissertations Abstracts International, Volume: 83-03, Section: B.

Thesis (Ph.D.)--Karolinska Institutet (Sweden), 2021.

This item must not be sold to any third party vendors.

The most common symptom of oesophageal cancer is difficulty swallowing, dysphagia, due to the tumour obstructing the oesophageal lumen often resulting in weight loss. In patients diagnosed with oesophageal cancer malnutrition is reported in 60-85%. Neoadjuvant treatment with subsequent oesophagectomy is the standard curative intent treatment in most countries. Neoadjuvant treatment, either neoadjuvant chemoradiotherapy (nCRT) or perioperative chemotherapy (pCT), might cause further symptoms affecting nutritional intake and thereby cause weight loss. Oesophagectomy is an extensive procedure where the oesophagus is removed and most often replaced with a gastric tube conduit affecting patients´ nutritional intake due to the altered anatomy. During recent years different minimally invasive techniques has been introduced in order to minimize the surgical trauma. Most of the patients receive a feeding jejunostomy during surgery securing nutritional intake during the time they, often, are restricted from eating orally and during the time they increase their oral intake.In Study I we assessed dysphagia in patients undergoing neoadjuvant treatment before oesophagectomy. Patients received either neoadjuvant chemotherapy (nCT) or nCRT, both with induction chemotherapy for 1 week. The dysphagia improved significantly after first cycle of chemotherapy with further improvements after completed neoadjuvant treatment. There was no correlation between dysphagia relief and histological response. In Study II we compared weight development after open Ivor Lewis oesophagectomy to minimally invasive Ivor Lewis oesophagectomy (MIIL) or minimally invasive McKeown oesophagectomy (MIMK). We found no significant difference between weight development after the greater surgical trauma associated with open surgery and the minimally invasive approaches. We saw a non-significant trend towards a lower risk of 10% or more weight loss at 3 months after surgery in case of severe postoperative complications after MIIL compared to open IL. In Study III we assessed the energy intake and the total energy expenditure (TEE) before and after neoadjuvant treatment and at 3 and 6 months after oesophagectomy. We found a negative energy balance at baseline and at 3 months after surgery. Mean weight decreased significantly at all time points compared to baseline with the greatest weight loss at 3 months postoperatively. In Study IV we compared weight and dysphagia development between standard and prolonged waiting time to oesophagectomy after completed nCRT. We also compared patients malnourished or not at baseline in each group for risk of postoperative complications. Patients gained weight during the prolonged time to surgery and almost returned to the same weight as at baseline. Dysphagia improved significantly in both groups, with a further but nonsignificant improvement during the prolonged time to surgery. Malnutrition at baseline did not affect postoperative complications between the groups.In conclusion, patients´ dysphagia improved during neoadjuvant treatment suggesting nutritional interventions as first line treatment awaiting effect of chemotherapy. There was no difference in weight loss between open and minimally invasive oesophagectomy. Results from this thesis also suggests that early nutritional interventions and follow up regarding energy and protein intake is important to maintain or prevent weight loss during the neoadjuvant treatment and during the first three postoperative months.

ISBN: 9798744472511Subjects--Topical Terms:

818532
Metastasis.

Nutritional Status and Dysphagia in Patients with Oesophageal Cancer - the Impact of Oncological and Surgical Treatment.
LDR:04774nmm a2200397 4500 001 2346611
005 20220620110657.5
008 241004s2021 ||||||||||||||||| ||eng d
020 $a 9798744472511
035 $a (MiAaPQ)AAI28470392
035 $a (MiAaPQ)Karolinska_1061647486
035 $a AAI28470392
040 $a MiAaPQ $c MiAaPQ
100 1 $a Ericson, Jessica. $3 3685736
245 1 0 $a Nutritional Status and Dysphagia in Patients with Oesophageal Cancer - the Impact of Oncological and Surgical Treatment.
260 1 $a Ann Arbor : $b ProQuest Dissertations & Theses, $c 2021
300 $a 87 p.
500 $a Source: Dissertations Abstracts International, Volume: 83-03, Section: B.
500 $a Advisor: Rouvelas, Ioannis;Nilsson, Magnus;Lindblad, Mats.
502 $a Thesis (Ph.D.)--Karolinska Institutet (Sweden), 2021.
506 $a This item must not be sold to any third party vendors.
520 $a The most common symptom of oesophageal cancer is difficulty swallowing, dysphagia, due to the tumour obstructing the oesophageal lumen often resulting in weight loss. In patients diagnosed with oesophageal cancer malnutrition is reported in 60-85%. Neoadjuvant treatment with subsequent oesophagectomy is the standard curative intent treatment in most countries. Neoadjuvant treatment, either neoadjuvant chemoradiotherapy (nCRT) or perioperative chemotherapy (pCT), might cause further symptoms affecting nutritional intake and thereby cause weight loss. Oesophagectomy is an extensive procedure where the oesophagus is removed and most often replaced with a gastric tube conduit affecting patients´ nutritional intake due to the altered anatomy. During recent years different minimally invasive techniques has been introduced in order to minimize the surgical trauma. Most of the patients receive a feeding jejunostomy during surgery securing nutritional intake during the time they, often, are restricted from eating orally and during the time they increase their oral intake.In Study I we assessed dysphagia in patients undergoing neoadjuvant treatment before oesophagectomy. Patients received either neoadjuvant chemotherapy (nCT) or nCRT, both with induction chemotherapy for 1 week. The dysphagia improved significantly after first cycle of chemotherapy with further improvements after completed neoadjuvant treatment. There was no correlation between dysphagia relief and histological response. In Study II we compared weight development after open Ivor Lewis oesophagectomy to minimally invasive Ivor Lewis oesophagectomy (MIIL) or minimally invasive McKeown oesophagectomy (MIMK). We found no significant difference between weight development after the greater surgical trauma associated with open surgery and the minimally invasive approaches. We saw a non-significant trend towards a lower risk of 10% or more weight loss at 3 months after surgery in case of severe postoperative complications after MIIL compared to open IL. In Study III we assessed the energy intake and the total energy expenditure (TEE) before and after neoadjuvant treatment and at 3 and 6 months after oesophagectomy. We found a negative energy balance at baseline and at 3 months after surgery. Mean weight decreased significantly at all time points compared to baseline with the greatest weight loss at 3 months postoperatively. In Study IV we compared weight and dysphagia development between standard and prolonged waiting time to oesophagectomy after completed nCRT. We also compared patients malnourished or not at baseline in each group for risk of postoperative complications. Patients gained weight during the prolonged time to surgery and almost returned to the same weight as at baseline. Dysphagia improved significantly in both groups, with a further but nonsignificant improvement during the prolonged time to surgery. Malnutrition at baseline did not affect postoperative complications between the groups.In conclusion, patients´ dysphagia improved during neoadjuvant treatment suggesting nutritional interventions as first line treatment awaiting effect of chemotherapy. There was no difference in weight loss between open and minimally invasive oesophagectomy. Results from this thesis also suggests that early nutritional interventions and follow up regarding energy and protein intake is important to maintain or prevent weight loss during the neoadjuvant treatment and during the first three postoperative months.
590 $a School code: 0658.
650 4 $a Metastasis. $3 818532
650 4 $a Cancer surgery. $3 3685737
650 4 $a Epidemiology. $3 568544
650 4 $a Nutrition research. $3 3564650
650 4 $a Cancer therapies. $3 3557730
650 4 $a Mortality. $3 533218
650 4 $a Risk factors. $3 3543864
650 4 $a Energy. $3 876794
650 4 $a Abdomen. $2 bidex $3 876514
650 4 $a Ethics. $3 517264
650 4 $a Stomach. $3 3685738
650 4 $a Statistical analysis. $3 3543751
650 4 $a Proteins. $3 558769
650 4 $a Patients. $3 1961957
650 4 $a Medical prognosis. $3 3561728
650 4 $a Smoking. $3 643634
650 4 $a Enteral nutrition. $3 3685739
650 4 $a Weight control. $3 3563046
650 4 $a Lymphatic system. $3 3685740
650 4 $a Obesity. $3 525736
650 4 $a Parenteral nutrition. $3 3685741
650 4 $a Pain. $3 533714
650 4 $a Tumors. $3 893964
650 4 $a Radiation therapy. $3 3557731
650 4 $a Chemotherapy. $3 728559
650 4 $a Therapy. $3 3343697
650 4 $a Nutrition. $3 517777
650 4 $a Medicine. $3 641104
650 4 $a Surgery. $3 707153
650 4 $a Philosophy. $3 516511
650 4 $a Morphology. $3 591167
690 $a 0287
690 $a 0791
690 $a 0766
690 $a 0394
690 $a 0564
690 $a 0570
690 $a 0422
690 $a 0576
690 $a 0212
710 2 $a Karolinska Institutet (Sweden). $3 3557748
773 0 $t Dissertations Abstracts International $g 83-03B.
790 $a 0658
791 $a Ph.D.
792 $a 2021
793 $a English
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28470392