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.

背景：术后体重丢失（Postoperative body weight loss, PBWL）与食管癌患者行食管切除术后的不良长期预后密切相关，因此围手术期营养支持至关重要。尽管机器人辅助经纵隔根治性食管切除术（robot-assisted radical transmediastinal esophagectomy, RA-TME）等微创手术术式日益普及，但营养护理领域仍未得到足够重视。本研究旨在评估静脉（intravenous, IV）氨基酸输注对RA-TME患者术后体重丢失的影响。

方法：本研究回顾性分析了2011至2022年间于我院接受RA-TME治疗的155例食管或食管胃结合部癌患者。将患者分为两组：AA(+)组（n=73，于术后第1~6日（postoperative days, POD）接受静脉氨基酸输注）与AA(–)组（n=82，未接受静脉氨基酸输注）。两组均在术后第6日之前禁止经口或肠内营养。对比两组的营养摄入情况、术后结局及营养状态。

结果：两组患者的基线特征、手术结局及并发症发生率均无显著差异。但AA(+)组的能量与营养摄入显著更高。术后2周的PBWL在AA(+)组显著低于AA(–)组（6.5% vs. 8.15%，p=0.0091）。

结论：静脉氨基酸输注或可降低RA-TME术后早期的PBWL。