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Annals of Surgical Oncology
Erschienen in:

20.02.2022 | Thoracic Oncology

Perioperative Ghrelin Administration Attenuates Postoperative Skeletal Muscle Loss in Patients Undergoing Esophagectomy for Esophageal Cancer: Secondary Analysis of a Randomized Controlled Trial

verfasst von: Yohei Nose, MD, Kotaro Yamashita, MD, PhD, Tomohira Takeoka, MD, PhD, Kota Momose, MD, PhD, Takuro Saito, MD, PhD, Koji Tanaka, MD, PhD, Kazuyoshi Yamamoto, MD, PhD, Tomoki Makino, MD, PhD, Tsuyoshi Takahashi, MD, PhD, Yukinori Kurokawa, MD, PhD, Makoto Yamasaki, MD, PhD, Osamu Shiraishi, MD, PhD, Hiroshi Miyata, MD, PhD, Takushi Yasuda, MD, PhD, Masahiko Yano, MD, PhD, Hidetoshi Eguchi, MD, PhD, Yuichiro Doki, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 6/2022

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Abstract

Background

Ghrelin has been reported to reduce postoperative weight loss by improving appetite and food intake in patients undergoing upper gastrointestinal surgery.

Objective

We aimed to investigate whether growth hormone induction, another essential effect of ghrelin, may attenuate skeletal muscle loss in patients during postoperative starvation.

Methods

Esophageal cancer patients were randomized to receive a continuous intravenous infusion of high-dose ghrelin (HD; 0.5 µg/kg/h), low-dose ghrelin (LD; 0.25 µg/kg/h), or placebo for 7 days after surgery. During this period, oral feeding was not introduced but the patients received the same parenteral and enteral nutrition. We investigated the effects of ghrelin on body weight, skeletal muscle mass, nutritional status, and hormone levels.

Results

Overall, 73 patients were enrolled in this study. The rate of weight loss on postoperative day (POD) 7 relative to that before surgery was significantly lower in the HD group than in the placebo group (HD vs. placebo: −0.61% vs. 1.8%, p = 0.030). The rate of muscle loss in the erector spinae muscle on POD 7 in the HD and LD groups was significantly lower than that in the placebo group (HD vs. placebo: 2.8% vs. 8.5%, p < 0.001; LD vs. placebo: 4.9% vs. 8.5%, p = 0.028). The levels of growth hormone on PODs 1, 3, and 7, and insulin-like growth factor 1 on PODs 3, 7, and 14 were significantly higher in patients who received ghrelin.

Conclusion

Continuous ghrelin administration could attenuate skeletal muscle loss in esophageal cancer patients during postoperative starvation.
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Metadaten
Titel
Perioperative Ghrelin Administration Attenuates Postoperative Skeletal Muscle Loss in Patients Undergoing Esophagectomy for Esophageal Cancer: Secondary Analysis of a Randomized Controlled Trial
verfasst von
Yohei Nose, MD
Kotaro Yamashita, MD, PhD
Tomohira Takeoka, MD, PhD
Kota Momose, MD, PhD
Takuro Saito, MD, PhD
Koji Tanaka, MD, PhD
Kazuyoshi Yamamoto, MD, PhD
Tomoki Makino, MD, PhD
Tsuyoshi Takahashi, MD, PhD
Yukinori Kurokawa, MD, PhD
Makoto Yamasaki, MD, PhD
Osamu Shiraishi, MD, PhD
Hiroshi Miyata, MD, PhD
Takushi Yasuda, MD, PhD
Masahiko Yano, MD, PhD
Hidetoshi Eguchi, MD, PhD
Yuichiro Doki, MD, PhD
Publikationsdatum
20.02.2022
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 6/2022
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-022-11436-0

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