Post-operative Medium Chain Triglyceride Diet May Reduce Hospital Stay Following Lung Resection

NCT ID: NCT07159659

Last Updated: 2025-09-08

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 210 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-09-01
• Study Completion Date: 2027-08-30

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.

Conditions

Thoracic Neoplasms

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Control Group

Patients in the control group will receive a standard hospital diet consistent with routine postoperative nutritional care after lobectomy with lymph node dissection. This diet does not include medium-chain triglyceride (MCT) supplementation and serves as a comparator to evaluate the effects of the MCT diet on postoperative recovery

Group Type: NO_INTERVENTION

No interventions assigned to this group

MCT diet during hospital stay

Patients will receive a medium-chain triglyceride (MCT)-enriched diet during their hospital stay following lobectomy with lymph node dissection. The MCT diet is administered as part of the postoperative nutritional regimen to evaluate its impact on recovery outcomes

Group Type: EXPERIMENTAL

MCT Diet

Intervention Type: DIETARY_SUPPLEMENT

MCT diet for patients following lung resection

MCT diet during hospital stay and 2 weeks after discharge

Participants will receive a medium-chain triglyceride (MCT) diet during their hospital stay and for two weeks following discharge. This aims to evaluate the effects of continued MCT dietary supplementation on postoperative recovery outcomes after lobectomy with lymph node dissection

Group Type: EXPERIMENTAL

MCT Diet

Intervention Type: DIETARY_SUPPLEMENT

MCT diet for patients following lung resection

Interventions

MCT Diet

MCT diet for patients following lung resection

Intervention Type: DIETARY_SUPPLEMENT

Eligibility Criteria

Inclusion Criteria

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

1. Contraindication to general anesthesia

2. Severe concomitant illness that drastically shortens life expectancy or increases the risk of therapeutic intervention

3. Untreated active infection

4. Non-correctable coagulopathy

5. Emergency surgery

6. Vulnerable population (e.g. mentally disabled, pregnancy)

Project-specific Criteria

1. Segmentectomy

2. Pleurodesis

3. Esophageal procedures

4. Redo/readmitted patients for lung resection

5. Chylothorax (Triglyceride > 110 mL, excluded at day 1 routine lab check)

6. Air leak (> 30 mL/min when back to ward)

7. Heart Failure

8. Renal failure (estimated GFR < 30; CKD grading stage 4-5)

9. Moderate to severe adhesion (defined at randomization by surgeon; criteria include estimated surface area of adhesion and staging)

10. History of tuberculosis or empyema

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Chinese University of Hong Kong

OTHER

Sponsor Role: lead

Responsible Party

Calvin Sze Hang Ng

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Prince of Wales Hospital

Shatin, , Hong Kong

Countries

Hong Kong

Central Contacts

Calvin Sze Hang Ng

Role: CONTACT

calvinng@surgery.cuhk.edu.hk

+852 3505 2618

Facility Contacts

Calvin Sze Hang Ng

Role: primary

calvinng@surgery.cuhk.edu.hk

+852 3505 2618

Other Identifiers

MCT Study Protocol version 1.1

Identifier Type: -

Identifier Source: org_study_id