Patients with short bowel syndrome (SBS) have a high risk of developing parenteral nutrition (PN)-associated complications. Therefore, diet or enteral nutrition and PN should be modified to limit such complications. N balance analysis is a method of calculating the amount of protein required to achieve N equilibrium in the body based on intake and excretion. It is important to reduce dependence on PN and achieve the recommended range of N balance 2–4 g with an appropriate diet. We report a recent experience with nutrition modification using N balance analysis and suggest it as a useful method to reduce dependence on PN in nutrition management of SBS patients and in continuing active intestinal rehabilitation.
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Esophagectomy can result in various postoperative nutrition-related complications that may impair the nutritional status of the patient. In our institution, we usually initiate 16-hour continuous jejunostomy feeding using an enteral feeding pump on postoperative day 2 as a routine protocol after esophagectomy. The target calorie intake was achieved in 6-7 days with this protocol, which is longer than that required with other recently reported feeding protocols. Accordingly, early jejunostomy feeding protocol, which starts on postoperative day 1 and continues for 24 hours was attempted. In the present report, we described 3 cases of early 24-hour continuous jejunostomy feeding after esophagectomy. The use of this new protocol reduced the duration required to achieve the target calorie intake as less than 5 days without any enteral feeding-related complications.
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