#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Preoperative non-selective administration of nutritional supplements to patients undergoing elective colorectal resection – standard of perioperative care?


Authors: M. Tesař 1,2;  P. Ostruzska 1;  V. Kožušníková 1;  L. Martínek 1,2 ;  M. Zádrapová 3;  L. Grasslová 3;  P. Ihnát 1,2
Authors place of work: Chirurgická klinika, Fakultní nemocnice Ostrava, Ostrava 1;  Katedra chirurgických oborů, Lekářská fakulta Ostravské univerzity, Ostrava 2;  Klinika rehabilitace a tělovýchovného lékařství, Fakultní nemocnice Ostrava, Ostrava 3
Published in the journal: Rozhl. Chir., 2022, roč. 101, č. 5, s. 232-238.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2022.101.5.232–238

Summary

Introduction: Preoperative nutritional support for oncosurgical patients is recommended to minimize the negative effects of potential malnutrition. Nutritional support is intended to adjust the pathophysiological reactions to surgery, reduce postoperative complications, shorten the length of hospital stay and speed up convalescence. The aim of the present study was to evaluate the effect of preoperative nutritional supplements (ONS − oral nutritional supplements) on the physical and nutritional status of patients undergoing elective colorectal resection for cancer and to assess patients’ self-sufficiency after surgery.

Methods: This was a prospective, randomized, single-center clinical trial designed to assess self-sufficiency and return to normal activities in relation to preoperative ONS in patients undergoing elective colorectal surgery. Patients enrolled in the study were randomized to receive ONS twice daily for 7 days prior to surgery or no ONS.

Results: One hundred patients were included in the study. The rate of postoperative complications was comparable; no differences were found in postoperative values of laboratory nutritional parameters (albumin, prealbumin). The length of hospital stay was comparable; the stay in the ICU was shorter in patients taking ONS but the difference was not statistically significant. Differences between the study subgroups regarding muscle weight were not statistically significant. Patient self-sufficiency (assessed using the Barthel index) was comparable in both groups before and after surgery (p=0.717 and p=0.327).

Conclusion: Non-selective preoperative administration of ONS to all patients undergoing elective colorectal resection does not reduce postoperative morbidity or speed up recovery. Patients’ self-sufficiency and their physical and nutritional status are not affected by preoperative nutritional support.

Keywords:

malnutrition – self-sufficiency – colorectal cancer – protein nutritional supplements – postoperative morbidity


Zdroje

1. Ferlay J, Ervik M, Lam F, et al. Global cancer observatory: Cancer today [on line]. Lyon, France, International Agency for Research on Cancer 2018. Available at: www: https://gco.iarc.fr/today.

2. Thoresen L, Frykholm G, Lydersen S, et al. Nutritional status, cachexia and survival in patients with advanced colorectal carcinoma. Different assessment criteria for nutritional status provide unequal results. Clin Nutr. 2013;32(1):65−72. doi:10.1016/j.clnu.2012.05.009.

3. Karlsson S, Andersson L, Berglund B. Early assessment of nutritional status in patients scheduled for colorectal cancer surgery. Gastroenterol Nurs. 2009;32(4):265−270. doi:10.1097/ SGA.0b013e3181aead68.

4. Weimann A, Braga M, Carli F, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017;36(3):623−650. doi:10.1016/j.clnu.2017.02.013.

5. Lassen K, Soop M, Nygren J, et al. Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. Arch Surg. 2009;144(10):961−969. doi:10.1001/archsurg.2009.170.

6. Bruns ERJ, Argillander TE, Van Den Heuvel B, et al. Oral nutrition as a form of pre-operative enhancement in patients undergoing surgery for colorectal cancer: A systematic review. Surg Infect (Larchmt) 2018;19(1):1–10. doi:10.1089/ sur.2017.143.

7. Braga M, Gianotti L, Vignali A, et al. Preoperative oral arginine and n-3 fatty acid supplementation improves the immunometabolic host response and outcome after colorectal resection for cancer. Surgery 2002;132(5):805−814. doi:10.1067/ msy.2002.128350.

8. Finco C, Magnanini P, Sarzo G, et al. Prospective randomized study on perioperative enteral immunonutrition in laparoscopic colorectal surgery. Surg Endosc. 2007;21(7):1175−1179. doi:10.1007/ s00464-007-9238-4.

9. Horie H, Okada M, Kojima M, et al. Favorable effects of preoperative enteral immunonutrition on a surgical site infection in patients with colorectal cancer without malnutrition. Surg Today 2006;36(12):1063−1068. doi:10.1007/ s00595-006-3320-8.

10. Burden ST, Hill J, Shaffer JL, et al. An unblinded randomised controlled trial of preoperative oral supplements in colorectal cancer patients. J Hum Nutr Diet. 2011;24(5):441−448. doi:10.1111/j.1365- 277X.2011.01188.x.

11. Gillis C, Loiselle SE, Fiore JF Jr, et al. Prehabilitation with whey protein supplementation on perioperative functional exercise capacity in patients undergoing colorectal resection for cancer: A pilot double-blinded randomized placebo- controlled trial. J Acad Nutr Diet. 2016;116(5):802−812. doi:10.1016/j. jand.2015.06.007.

12. Maňásek V, Bezděk K, Foltys A, et al. The impact of high protein nutritional support on clinical outcomes and treatment costs of patients with colorectal cancer. Klin Onkol. 2016;29(5):351−357.

13. Kondrup J, Rasmussen HH, Hamberg O, et al. Ad Hoc ESPEN Working Group. Nutritional risk screening (NRS 2002): a new method based on analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321−336. doi:10.1016/s0261- 5614(02)00214-5.

14. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205−213. doi:10.1097/01.sla.0000133083.54934. ae.

15. MacFie J, Woodcock NP, Palmer MD, et al. Oral dietary supplements in preand postoperative surgical patients: a prospective and randomized clinical trial. Nutrition 2000;16(9):723−728. doi:10.1016/s0899-9007(00)00377-4.

16. Smedley F, Bowling T, James M, et al. Randomized clinical trial of the effects of preoperative and postoperative oral nutritional supplements on clinical course and costof care. Br J Surg. 2004;91(8):983−990. doi:10.1002/bjs.4578.

17. Gillis C, Buhler K, Bresee L, et al. Effects of nutritional prehabilitation, with and without exercise, on outcomes of patients who undergo colorectal surgery: A systematic review and meta-analysis. Gastroenterology. 2018;155(2):391−410.e4. doi:10.1053/j.gastro.2018.05.012.

18. Thoresen L, Frykholm G, Lydersen S, et al. Nutritional status, cachexia and survival in patients with advanced colorectal carcinoma. Different assessment criteria for nutritional status provide unequal results. Clin Nutr. 2013;32(1):65−72. doi:10.1016/j.clnu.2012.05.009.

19. Stratton, RJ, Green CJ, Ella M. Disease-related malnutrition: An evidence-based approach to treatment. CABI Publishing 2003.

20. Lopes JP, de Castro Cardoso Pereira PM, dos Reis Baltazar Vicente AF, et al. Nutritional status assessment in colorectal cancer patients. Nutr Hosp. 2013;28(2):412−418. doi:10.3305/ nh.2013.28.2.6173.

21. Buzby GP, Mullen JL, Matthews DC, et al. Prognostic nutritional index in gastrointestinal surgery. Am J Surg. 1980;139(1):160−167. doi:10.1016/0002- 9610(80)90246-9.

22. Detsky AS, Baker JP, O‘Rourke K, et al. Predicting nutrition-associated complications for patients undergoing gastrointestinal surgery. JPEN J Parenter Enteral Nutr. 1987;11(5):440−446. doi:10.1177/0 148607187011005440.

23. Dempsey DT, Mullen JL, Buzby GP. The link between nutritional status and clinical outcome: can nutritional intervention modify it? Am J Clin Nutr. 1988;47(2 Suppl): 352−356. doi:10.1093/ajcn/47.2.352.

24. Klidjian AM, Foster KJ, Kammerling RM, et al. Relation of anthropometric and dynamometric variables to servus postoperative complications. Br Med J. 1980;281(6245):899−901. doi:10.1136/ bmj.281.6245.899.

Štítky
Surgery Orthopaedics Trauma surgery

Článok vyšiel v časopise

Perspectives in Surgery

Číslo 5

2022 Číslo 5
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#