SERIAL CHANGES IN CONTRIBUTION OF SUBSTRATES TO ENERGY-EXPENDITURE AFTER TRANSTHORACIC ESOPHAGECTOMY FOR CANCER

This study was designed to examine the metabolic response of patients following transthoracic esophagectomy for carcinoma of the esophagus d uring the administration of total parenteral nutrition. Thirty-five pa tients underwent a right thoracotomy and transthoracic esophagectomy w ith nodal dissection in the neck, mediastinum, and abdomen. The restin g energy expenditure (REE) was measured preoperatively, and on the 1st , 3rd, 5th, and 7th postoperative days (PODs) using indirect calorimet ry. The REE was significantly higher following transthoracic esophagec tomy on PODs 1, 3, 5, and 7 than preoperatively. The caloric contribut ion of fat was significantly less on the 3rd, 5th, and 7th PODs than o n the Ist POD. Ln contrast, carbohydrate oxidation increased significa ntly on the 3rd, 5th, and 7th PODs compared to that of the Ist POD. Th ese results may help optimize the nutritional support regimen for post -esophagectomy patients. (C) Elsevier Science Inc.