Perioperative Artificial Enteral Nutrition in Malnourished Esophageal and Stomach Cancer Patients and its Impact on Postoperative Complications
Journal Title: Indian Journal of Nutrition - Year 2018, Vol 5, Issue 2
Abstract
Introduction: The cancer is responsible for approximately 13% of all causes of death worldwide, however the death of almost 20% of cancer patients occurs as a result of malnutrition and its complications, rather than the malignancy itself. Malnutrition is common in gastrointestinal cancer patients, more so in cancer of stomach and esophagus. The causes are often complex and multi-factorial. Although it is widely accepted that malnutrition adversely affects the postoperative outcome of patients, there is little evidence that perioperative nutrition support can reduce surgical risk in malnourished cancer patients. Materials and Methods: This prospective study was carried out from December 2016 to July 2017 at the Kidwai memorial institute of oncology Bengaluru. Within 48 h of admission, patients underwent nutritional assessment by the subjective global assessment. Perioperative nutrition was administered in the study group by enteral route only. Patients had a functioning gastrointestinal tract, and they received Enteral Nutrition (EN). Target intake of non-protein (25 kcal/kg per day) and protein (0.25 g nitrogen/kg per day) was provided using available enteral formulas. This was supplementary to standard hospital diet. Results: Nutritional re-assessment after 15 days of intervention showed significant change in nutritional status, which was measured as gain in weight for each patient. There were significant differences in the mortality and complications between the two groups. The total length of hospitalization and postoperative stay of the control patients were significantly longer than those of the study patients. Conclusion: In conclusion, perioperative nutrition support can decrease the incidence of postoperative complications in moderately- and severelymalnourished gastric and esophageal cancer patients. In addition, it is effective in reducing mortality. Enteral nutrition support, ALONE can be used in the management of malnourished patients undergoing gastric and esophageal surgery.
Authors and Affiliations
Veerendra Kumar KV
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