Body mass index kinetics and risk factors of malnutrition one year after radical oesophagectomy for cancer

Abstract

Postoperative malnutrition remains a severe problem after oesophageal cancer resection, even in long-term disease-free survivors. Overweight and obese patients are the segment population most exposed to this postoperative malnutrition, suggesting that such surgery could have substantial bariatric effect. A special vigilance programme on the nutritional status of this sub-group of patients should be the rule.

A systematic review of the nutritional consequences of esophagectomy

“…Further details of the studies are given in Table 1. In general, all studies were considered deficient in one or more aspects of their study design/ reporting, which increased the likelihood of bias. In terms of selection, no eligibility criteria were reported in two studies [17,26], one prospective study used consecutive patients attending outpatient clinics [18] and all others used convenient samples from defined time periods [19][20][21][22][23][24][25][27][28][29][30][31][32][33]. Participation rate was reported in 16 of the 18 studies, and ranged between 66 and 100%.…”

“…No study justified the sample sized used. In terms of attrition bias, five of the 13 studies reported complete outcome data [20,21,26,32,33].…”

“…A number of studies considered the frequency of malnutrition, defined by a greater than 10% or 15% loss of baseline weight [21,28,29,32] These found that at six and 12 months after surgery, more than half of the patients had lost more than 10% of their initial weight.…”

“…Two studies considered factors associated with postoperative weight loss [29,32]. Premorbid BMI was identified in both studies as a significant factor, with those with higher BMIs losing more weight preoperatively but comparatively less, postoperatively.…”

“…Ouattara et al [32] % of patients with ≥15% weight loss n/r n/r 29% 25% n/r Koizumi et al [26] Absolute change in BMI (kg/m 2 ). −1.9 (2.3) n/r −2.3 (1.8) −2.4 (2.7) n/r Ludwig et al [27] Absolute change in weight (kg) n/r n/r −10 (8) kg −3 (3) kg n/r BMI = body mass index, m = months, n/r = not reported, wk = week, yr = year.…”