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| Application of nutritional therapy for modified jejunostomy in patients with esophageal cancer and construction of prognostic
risk model |
| Wu Haiyan, Xu Jingjing, Chen Chen, Wu Chenchen, Lu Dongmei, Yin Tianjiao |
| Cardiothoracic Surgery Department Huai'an First Hospital Affiliated to Nanjing Medical University Huai'an First People's Hospital
Huai'an 223300 Jiangsu China |
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Abstract Objective To explore the application effect of modified jejunostomy nutrition support in esophageal cancer and construct
the risk prediction model of complications. Method Retrospective analysis of 197 esophageal cancer patients was collected from the
First Hospital of Huai 'an affiliated to Nanjing Medical University / First People's Hospital of Huai 'an City from April 2020 to October
2023. The patients were divided into two groups based on treatment methods the control group of 98 cases received nasogastric tube
insertion while the experimental group of 99 cases received modified jejunal stoma for nutritional support. The study compared the
nutritional indicators and complication rates during the treatment period at 14 days post-intervention. Additionally the incidence of
postoperative complications was recorded and divided into two groups the group with complications n = 24 and the group without
complications n = 173 . For indicators showing differences in univariate analysis binary Logistic regression was used to identify
independent factors influencing postoperative complications and the evaluation effectiveness of the binary logistic regression model was
verified. The above procedures were summarized for the training group. Result The total protein albumin and hemoglobin levels in
the intervention group were higher than those in the control group after the trial with a lower incidence of postoperative complications
compared to the control group and the difference was statistically significant P<0. 05 . Univariate analysis showed that age surgery
duration alcohol consumption history anastomosis site nutritional risk and intervention method had an impact on postoperative
complications P<0. 05 . Bivariate Logistic regression analysis revealed that age ≥60 years surgery duration < 240 min alcohol consumption history anastomosis site at the neck nutritional risk and nasogastric tube use were independent risk factors for
postoperative complications in esophageal cancer patients P<0. 05 . The samples of all the studies are divided into the training set and
the validation set. An evaluation model was established based on these risk factors with the training set showing an AUC of 0. 840 a
95%CI of 0. 766 to 0. 913 a specificity of 75. 10% and a sensitivity of 79. 20% the validation set had an AUC of 0. 828 a 95%CI
of 0. 711 to 0. 944 a specificity of 98. 84% and a sensitivity of 66. 67% indicating that the model has good discriminative
power. Conclusion Compared to nasogastric tube insertion modified jejunal stoma nutrition support can better improve the
postoperative nutritional status of esophageal cancer patients. However postoperative complications are still influenced by factors such
as nastomosis site age alcohol consumption history nutritional risk intervention method and surgery duration. Therefore it is
essential to focus on these risk factors and implement corresponding preventive and intervention measures to reduce postoperative
complications in esophageal cancer patients and improve patient outcomes.
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