Actual postoperative protein and calorie intake in patients undergoing major open abdominal cancer surgery: A prospective, observational cohort study

Abstract

Background: Adequate nutritional protein and energy intake are required for optimal postoperative recovery. There are limited studies reporting the actual postoperative protein and energy intake within the first week after major abdominal cancer surgery. The main objective of this study was to quantify the protein and energy intake after major abdominal cancer surgery. Methods:We conducted a prospective cohort study. Nutrition intake was assessed with a nutrition diary. The amount of protein and energy consumed through oral, enteral, and parenteral nutrition was recorded and calculated separately. Based on the recommendations of the European Society for Clinical Nutrition and Metabolism (ESPEN), protein and energy intake were considered insufficient when patients received <1.5 g/kg protein and 25 kcal/kg for 2 or more days during the first postoperative week.Results: Fifty patients were enrolled in this study. Mean daily protein and energy intake was 0.61 ± 0.44 g/kg/day and 9.58 ± 3.33 kcal/kg/day within the first postoperative week, respectively. Protein and energy intake were insufficient in 45 [90%] and 41 [82%] of the 50 patients, respectively. Patients with Clavien-Dindo grade ≥III complications consumed less daily protein compared with the group of patients without complications and patients with grade I or II complications. Conclusion:During the first week after major abdominal cancer surgery, the majority of patients do not consume an adequate amount of protein and energy. Incorporating a registered dietitian into postoperative care and adequate nutrition support after major abdominal cancer surgery should be a standard therapeutic goal to improve nutrition intake.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Inflection-Point Nutrition Support Determined by Oral Mucosal Apoptosis Rate Is a Novel Assessment Strategy for Personalized Nutrition: A Prospective Cohort Study

“…Deficiency in traditional nutritional evaluation and supply methods were major causes for inadequate postoperative nutrition intake. It has been reported that most patients that underwent major abdominal surgery did not consume adequate protein and energy after surgery [ 28 ]. Inadequate protein and energy intake may be correlated with poor surgical outcomes such as higher complication risk and longer hospital stay [ 29 ].…”

Oral Nutritional Supplements and Enteral Nutrition in Patients with Gastrointestinal Surgery

“…In a prospective study with 50 patients undergoing major abdominal surgery, the protein and calorie intake in the first postoperative week was recorded. In the majority of patients, the energy and protein intake was insufficient (82% and 90%, respectively), leading to more Clavien-Dindo III complications in patients who did not meet their protein targets [53]. In terms of nutritional medicine, it must be emphasized that an early oral diet is feasible but that the oral calorie requirement is not met over a longer period of time comprising the time after discharge, even after post-inpatient, and thus initiates weight loss.…”

Update enterale und parenterale Ernährung

“…Die EOF-Gruppe zeigte einen früher einsetzenden Flatus (2,9 vs. 3,1 Tage, p = 0,013), die Länge der Krankenhausverweildauer war signifikant kürzer (8,9 ± 5,7 vs. 12,6 ± 10,2 Tage, p < 0,01). Kein signifikanter Unter-schied bestand in Morbidität und Letalität, wobei die EOF-Gruppe eine signifikant niedrigere Rate abdomineller Infektionen (3,0 % vs. 7,4 %, p = 0,044) und Anastomoseninsuffizienzen hatte (1,5 % vs. 4,9 %, p = 0,048) [29]. Eine Subgruppenanalyse auf der Basis von Alter, Geschlecht, Operationsverfahren, Lymphknotendissektion und Tumorstadium ergab ebenfalls kein erhöhtes Risiko der frühzeitigen oralen Nahrungszufuhr für die Morbidität oder die Entwicklung einer Anastomoseninsuffizienz.…”

“…90 %). Bei den Patienten, die das Proteinziel nicht erreichten, wurden zudem mehr Clavien-Dindo-III-Komplikationen beobachtet [29]. Aus ernährungsmedizinischer Sicht ist die orale Nahrungsaufnahme machbar.…”