Thoracic Neoplasms
Conditions
Keywords
Medium Chain Triglyceride Diet, Lung Resection, Video-assisted thoracoscopic surgery
Brief summary
Lung resection, a critical treatment for various thoracic diseases, including lung cancer, often necessitates prolonged hospitalization due to rare but severe postoperative complications such as chyle leaks, with an occurrence of 0.25%-3%, prolonging chest drainage, and delaying recovery. Therefore, effective postoperative care is essential for optimizing outcomes, reducing complications, and expediting recovery. Recent studies have highlighted the significant potential of medium-chain triglyceride (MCT) diets, owing to their unique absorption pathway and metabolic properties. MCT contains mainly medium-chain fatty acids (MCFA), which is absorbed in the intestine and transported to the liver via the portal system instead of the lymphatic system. This helps to bypass the lymphatic system, thereby reducing the volume of lymph. MCFAs also provide better energy utilization in stressed condition since it does not require carnitine shuttle upon metabolism, which is beneficial to post-operation recovery. Several studies have demonstrated the benefits of MCT diets in managing chyle leaks and supporting gastrointestinal recovery, particularly in conditions that strain the lymphatic system. For instance, short-term MCT-enriched diets have been associated with improved post-operation recovery of gastrointestinal, hepatic and renal functions, reduced total chest drainage volumes, and shorter hospital stay when compared to regular diet groups. Patients with post-operative chyle leak following thoracic surgery are often given an MCT diet to reduce chest drain volume and hence shorten hospital stay. Based on the successful use of MCT diet on patients with chyle leak after lobectomy, it is hypothesized that patients with chylothorax provided with post-operative MCT diet can also shorten hospital stay by decreasing chest drainage. Therefore, a prospective and randomized trial is designed to investigate how post-operative MCT diet in lung resection patients without chylothorax may affect hospital stay and post-operative recovery.
Detailed description
This study is a single-center, prospective, randomized trial designed to investigate how a post-operative diet enriched with MCT affects recovery in patients undergoing video-assisted thoracic surgery (VATS). Medical students from the Chinese University of Hong Kong, under the supervision of the principal investigator, will conduct the study, including obtaining consent and collecting data. Experienced surgeons at the Prince of Wales Hospital will perform the VATS procedures. 2.2 Hypotheses 1. MCT diet can speed up post-operative recovery and shorten hospital length of stay. 2. MCT diet poses no adverse effects in post-operative recovery for patients without chyle leak following lung surgery. 3. The use of MCT diet after discharge for 2 weeks can enhance patient recovery and possibly reduce readmissions or complications.
Interventions
DIETARY_SUPPLEMENTMCT Diet
MCT diet for patients following lung resection
Sponsors
Chinese University of Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
General Inclusion Criteria for All procedures: 1. Age between 18 - 80 years 2. Body mass index \<35 kg/m2 3. Suitable for minimally invasive surgery 4. Willingness to participate as demonstrated by giving informed consent Project-specific Criteria: 1\. Patients performed lobectomy with lymph node dissection
Exclusion criteria
Patient general
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| hospital length of stay (LOS) | From the end of the lung resection procedure until the time of patient discharge, assessed up to 7 days post-surgery | hospital length of stay (LOS), which is hypothesized to be reduced following the administration of an MCT diet. Currently, patients undergoing lobectomy using VATS have a median LOS of approximately 3-4 days. The study aims to investigate whether MCT diet interventions can reduce this to 2 days, representing a 30% reduction in hospital stay. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total Chest Drain Output (mL) | From the end of the lung resection procedure until the time of chest drain removal assessed up to 7 days post-surgery | Chest drain output indirectly reflects recovery status. The total chest drain output will be measured using the Medela digital chest drainage system, which is routinely used for patients undergoing lobectomy. Compared to manual drainage system, this system allows more precise monitoring of fluid output. This information will help evaluate the overall impact of the MCT diet on postoperative recovery, particularly in reducing fluid drainage. |
| Patient Satisfaction and Tolerability | Upon discharge (assessed up to 7 days post-surgery), 2 weeks post discharge, 3 months post discharge | Patient-reported outcomes will be assessed using a quality of life (QoL) questionnaire, which is an established tool for evaluating recovery after surgery. The questionnaire will include: * Patient satisfaction with their recovery process * Tolerability of the MCT diet * Any challenges experienced during the diet, including adherence and acceptability |
| Number of Participants with Symptoms Associated with MCT Diet | Upon discharge (assessed up to 7 days post-surgery), 2 weeks post discharge, 3 months post discharge | Patients will be monitored for any gastrointestinal discomfort associated with the MCT diet, including: * Diarrhea * Constipation * Bloating * Increased flatus Reports of these symptoms will be collected during the hospital stay and follow-up visits to assess the safety and tolerability of the MCT diet. |
| Number of patients with Infection symptoms | Upon discharge (assessed up to 7 days post-surgery), 2 weeks post discharge, 3 months post discharge | · Observing for symptoms such as fever or shortness of breath (SOB), which will be incorporated into the QoL questionnaire |
| Number of patients with infection risk | Upon discharge (assessed up to 7 days post-surgery), 2 weeks post discharge, 3 months post discharge | Regular checks for pleural-based complications, such as effusion, through chest X-rays (performed before discharge and during follow-ups) |
Countries
Hong Kong
Contacts
CONTACTCalvin Sze Hang Ng
Outcome results
None listed