PP059-MON THE PROGNOSIS OF INCURABLE CACHECTIC CANCER PATIENTS ON HOME PARENTERAL NUTRITION

of this study was to evaluate the impact of an enhanced recovery after surgery (ERAS) program in patients who underwent a transthoracic esophagectomy. Methods: Between 2007 and 2010, 80 patients who underwent a transthoracic esophagectomy were put enrolled into the ERAS program which included early postoperative enteral nutrition and mobilization (Group A). The program was started on the first postoperative day (POD 1). This group was compared with a group of 80 patients who had been treated between 2002 and 2005 and had received the traditional post-operative regimen, including total parenteral nutrition (Group B). Mobilization was initiated on POD 2 in the Group B patients. Routine postoperative broncoscopy for toiletting sputum were performed in all patients in Group B, but only done when considered to be necessary in Group A. The outcome measures comprised the mortality rate, morbidity rate, postoperative pneumonia, surgical site infection (SSI), and length of postoperative hospital stay. This was a retrospective cohort study using historical controls. Differences between groups were examined for statistical significance using the chi-square, Fisher’s exact test or the Mann Whitney U-test. Results: The mortality rate was zero in both groups. The morbidity, postoperative pneumonia and SSI rates were 44%, 7% and 23%, and 75%, 16% and 41%, in Groups A and B, respectively (P= 0.001, 0.048, and 0.01). The length of postoperative hospital stay was reduced in Group A in comparison to that in Group B (median 22.2 versus 26.8 days; P= 0.03). Conclusion: The ERAS program after transthoracic esophagectomy was found to reduce the morbidity rate, especially infectious complications. Routine postoperative broncoscopy was found to be unnecessary in most patients.