Edward Shang

Retraction: The Influence of Early Supplementation of Parenteral Nutrition on Quality of Life and Body Composition in Patients With Advanced Cancer

The authors of the above article have requested its withdrawal, notifying the Journal that the clinical trials described in the article were not conducted as written in the article. The Editor-in-Chief, the American Society for Parenteral and Enteral Nutrition, and the Publisher have determined to retract the article.

‘Fast-track’ colonic surgery in Austria and Germany – results from the survey on patterns in current perioperative practice

Objective ‘Fast‐track’ rehabilitation has been shown to accelerate recovery, reduce general morbidity and decrease hospital stay after elective colonic surgery. Despite this evidence, there is no information on the acceptance and utilization of these concepts among the entirety of Austrian and German surgeons.

Early supplementation of parenteral nutrition is capable of improving quality of life, chemotherapy-related toxicity and body composition in patients with advanced colorectal carcinoma undergoing palliative treatment: results from a prospective, randomized clinical trial.

Aim  Patients suffering from advanced colorectal cancer can experience unintended weight loss and/or treatment‐induced gastrointestinal toxicity. Based on current evidence, the routine use of parenteral nutrition (PN) for patients with colorectal cancer is not recommended. This study evaluates the effect of PN supplementation on body composition, quality of life (QoL), chemotherapy‐associated side effects and survival in patients with advanced colorectal cancer.

Doxorubicin and mitoxantrone drug eluting beads for the treatment of experimental peritoneal carcinomatosis in colorectal cancer.

We investigated the therapeutic efficiency of sulfonate‐modified polyvinyl alcohol beads loaded with doxorubicin, irinotecan or mitoxantrone in vitro and in vivo in a model of experimental peritoneal carcinomatosis (PC). In vitro, cell proliferation was efficiently impaired by doxorubicin drug eluting bead (DEB) treatment while mitoxantrone DEBs were less effective than. Irinotecan showed little effect for both DEBs and free drug. Apoptosis was not different between free mitoxantrone and the DEB form while more apoptosis induction was observed in cells incubated with free doxorubicin and irinotecan. Experimental PC was produced in mice. The therapeutic efficiency of either mitoxantrone and doxorubicin DEB or free drugs were compared. Mice were treated either once on day 12 or by 3 repetitive applications on days 7, 10 and 12. Mice treated by DEBs showed less weight loss and mortality. Therapeutic effect was determined by measuring tumor volume and tumor load on the day 15 after tumor inoculation. For the single application on the day 12, an advantage could be observed for the free drugs. After 3 repeated injections of both free and mitoxantrone DEB no difference in tumor load or tumor volume could be observed. Least tumor load and tumor volume was observed in mice that received 3 repeated injections of doxorubicin DEB. No animal survived 3 injections of free doxorubicin. We conclude that bead encapsulation of chemotherapeutic drugs may show the advantage of less toxicity in peritoneal spread of colorectal cancer.

Current perioperative practice in rectal surgery in Austria and Germany.

Objective‘Fast-track’ rehabilitation is able to accelerate recovery, reduce general morbidity, and decrease hospital stay. This is widely accepted for colonic resections. Despite recent evidence that fast track concepts are safe and feasible in rectal resection, there is no information on the acceptance and utilization of these concepts among Austrian and German surgeons.MethodA questionnaire concerning perioperative routines in elective, open rectal resection was sent to the chief surgeons of 1,270 German and 120 Austrian surgical centers.ResultsThe response rate was 63% in Austria (76 centers) and 30% in Germany (385 centers). Mechanical bowel preparation is only abandoned by 2% of the Germany and 7% of the Austrian surgeons. Nasogastric decompression tubes are rarely used; four of five of the questioned surgeons in both countries use intra-abdominal drains. Half of the surgical centers allow the intake of clear fluids on the day of surgery. Mobilization starts in half of the centers on the day of surgery. Epidural analgesia is used in three-fourths of the institutions. Institutions which have implemented fast track rehabilitation for rectal resections discharge the patients earlier then hospitals that adhere to traditional care.ConclusionIn many perioperative procedures, Austrian and German Surgeons rely on their traditional approaches. Recent evidence-based adaptations of perioperative routines in rectal resections are only slowly introduced into daily routine; therefore, further efforts have to be done to optimizing patients’ care.

Pump-assisted enteral nutrition can prevent aspiration in bedridden percutaneous endoscopic gastrostomy patients.

BACKGROUND Vomiting, aspiration, and pneumonia are serious side effects in enteral feeding via percutaneous endoscopic gastrostomy (PEG), which often leads to hospitalization. To this day, it has not been proven whether pump-assisted (PA) or gravity-controlled application is the safer method for long-term feeding via PEG in bedridden patients. METHODS This study was conducted as a prospective, randomized crossover study. Fifty bedridden PEG patients were fed using the pump-assisted method (G1) and 50 patients were fed using the gravity-controlled feeding method (G2). After 6 weeks of observation (O1), the feeding methods in both groups were switched, followed by another 6 weeks of observation (O2). Daily recording was done using a standardized questionnaire. The glucose levels during O1 and O2 were determined on days 1, 21, and 42. RESULTS The patients in both groups were compatible in age, sex, and medical illness. By comparing G1 and G2, a significantly lower regurgitation rate (p < .0002), vomiting of feeding substrate (p < .009), aspiration (p < .01), and pneumonia (p < .02) was observed. The diarrhea rate in G2 was higher than in G1 (p < .007). The glucose profiles in G1 showed a significantly better development (p < .0007) than the ones in G2. After switching the application method in G2, the PA group (now G2) showed a significantly improved rate of regurgitation, vomiting, aspiration, and diarrhea and improved glucose profiles. CONCLUSION Feeding via PA shows improved safety, which is documented in a lower rate of diarrhea, regurgitation, vomiting, and aspiration. PA also noted a more effective glucose metabolization, which results in better glucose levels. As a result of this prospective study, pump-assisted feeding is recommended for bedridden patients requiring long-term feeding via PEG.

Retraction: Pump-Assisted Versus Gravity-Controlled Enteral Nutrition in Long-Term Percutaneous Endoscopic Gastrostomy Patients: A Prospective Controlled Trial

The authors of the above article have requested its withdrawal, notifying the Journal that the clinical trials described in the article were not conducted as written in the article. The Editor-in-Chief, the American Society for Parenteral and Enteral Nutrition, and the Publisher have determined to retract the article.