The Impact of Enteral Nutritional Support on Surgical Complications and Clinical Efficacy in Children With Neuroblastoma With Moderate or High Nutritional Risk.

چکیده اصلی

AIM: This study aims to investigate the association between enteral nutritional support, surgical complication rates, and the nutritional improvement effect in pediatric neuroblastoma (NB) patients. METHODS: This retrospective cohort study enrolled 94 neuroblastoma patients (≤14 years old) with moderate or high nutritional risk who underwent treatment at Hunan Children's Hospital between August 2019 and October 2021. Patients were assigned to a control group (n = 45), who received routine dietary guidance, and an experimental group (n = 49), who received enteral nutritional support along with routine dietary guidance. Group assignment indicated clinical decision-making by the treating clinicians, taking into account various parameters such as the children's tolerance to oral intake, the severity of digestive tract symptoms, the Nutrition Screening Tool for Childhood Cancer (SCAN) score, and caregivers' preferences. These clinical considerations were combined with input from caregivers when determining the nutritional protocol. The nutritional status, daily energy intake, and incidence of complications after surgery and chemotherapy were compared between groups. RESULTS: Before treatment, no statistically meaningful variations in all indicators were observed between groups (p > 0.05). After surgery and chemotherapy, the experimental group showed substantially higher levels of physical indicators (mid-upper arm circumference [MUAC], triceps skinfold thickness [TSFT] and biochemical indicators (hemoglobin [Hb] and prealbumin [Pre-Alb]) than the control group (p < 0.05)). After surgery and chemotherapy, the experimental group exhibited substantially higher average daily energy and protein intake levels compared with the control group (p < 0.05). Additionally, the experimental group had significantly lower rates of postoperative complications (4.1% versus 24.4%, risk ratio [RR] = 0.168, 95% confidence interval [CI]: 0.041-0.690) and post-chemotherapy complications (2.0% versus 15.6%, RR = 0.128, 95% CI: 0.017-0.967) than the control group (p < 0.05). No adverse events related to enteral nutritional support occurred in the experimental group during the intervention period. CONCLUSIONS: Enteral nutritional support can substantially improve the nutritional status and daily energy intake in neuroblastoma patients with moderate or high nutritional risk. This intervention can further decrease the likelihood of complications after surgery and chemotherapy.

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