Enteral versus parenteral nutrition in the conservative treatment of upper gastrointestinal fistula after surgery: a multicenter, randomized, parallel-group, open-label, phase III study (NUTRILEAK study).

Fiche publication


Date publication

juin 2020

Journal

Trials

Auteurs

Membres identifiés du Cancéropôle Est :
Pr ORTEGA DEBALLON Pablo, Pr PESSAUX Patrick


Tous les auteurs :
Gronnier C, Chambrier C, Duhamel A, Dervaux B, Collet D, Vaudoyer D, Régimbeau JM, Jougon J, Théréaux J, Lebreton G, Veziant J, Valverde A, Ortega-Deballon P, Pattou F, Mathonnet M, Perinel J, Beyer-Berjot L, Fuks D, Rouanet P, Lefevre JH, Cattan P, Deguelte S, Meunier B, Tuech JJ, Pessaux P, Carrere N, Salame E, Benaim E, Dousset B, Msika S, Mariette C, Piessen G,

Résumé

Postoperative upper gastrointestinal fistula (PUGIF) is a devastating complication, leading to high mortality (reaching up to 80%), increased length of hospital stay, reduced health-related quality of life and increased health costs. Nutritional support is a key component of therapy in such cases, which is related to the high prevalence of malnutrition. In the prophylactic setting, enteral nutrition (EN) is associated with a shorter hospital stay, a lower incidence of severe infectious complications, lower severity of complications and decreased cost compared to total parenteral nutrition (TPN) following major upper gastrointestinal (GI) surgery. There is little evidence available for the curative setting after fistula occurrence. We hypothesize that EN increases the 30-day fistula closure rate in PUGIF, allowing better health-related quality of life without increasing the morbidity or mortality.

Mots clés

Conservative treatment, Enteral nutrition, Parenteral nutrition, Randomized controlled trial, Upper gastrointestinal fistula

Référence

Trials. 2020 Jun 2;21(1):448