Peripheral vein infusions of amino acids prevent early postoperative weight loss after robot-assisted radical transmediastinal esophagectomy

Background Postoperative body weight loss (PBWL) is linked to poor long-term outcomes after esophagectomy for esophageal cancer, making perioperative nutrition critical. Despite the rise of minimally invasive procedures like robot-assisted radical transmediastinal esophagectomy (RA-TME), nutritional care has received less focus. This study evaluates the effect of intravenous (IV) amino acid infusions on PBWL in RA-TME patients. Methods We retrospectively analyzed 155 patients who underwent RA-TME for esophageal or esophagogastric junction cancer from 2011 to 2022 at our hospital. Patients were divided into two groups: AA(+) (n=73, received IV amino acids between postoperative days (POD) 1–6) and AA(–) (n=82, did not). Oral or enteral nutrition was withheld until POD6. Nutrient intake, postoperative outcomes, and nutritional status were compared. Results Patient backgrounds, surgical outcomes, and complications were similar between groups. However, the AA(+) group received significantly more energy and nutrients. PBWL at 2 weeks post-surgery was significantly lower in AA(+) than AA(–) (6.5% vs. 8.15%, p=0.0091). Conclusions IV amino acid infusion may help reduce early PBWL after RA-TME.