Early postoperative feeding following surgery for upper gastrointestinal cancer: A systematic review

Abstract

I N TRODUC TIONUpper gastrointestinal (UGI) cancers, specifically oesophageal and gastric cancers, account for almost 10% of new cancer cases globally and approximately 13% of cancer mortality. 1 Surgical resection, with or without neoadjuvant and adjuvant therapies, remains the basis of curative intent treatment for this cancer group. These procedures are significant and not without a high risk of complications, such as anastomotic leak and impacts on morbidity, mortality and quality of life (QOL), which are of significant concern to medical teams. [2][3][4][5] Post major UGI surgery, enteral or parenteral nutrition or the timing or type of oral diet, is a significant consideration known to affect postoperative recovery and the ability to tolerate adjuvant treatment. 5 Despite its importance, there

Construction and validation of a predictive model for the risk of three-month-postoperative malnutrition in patients with gastric cancer: a retrospective case-control study

“…EN also provides heat and nitrogen sources, promotes the synthesis of total proteins and stress proteins, corrects the negative nitrogen balance, improves immune capacity, and reduces postoperative inflammatory reactions. Carmichael et al showed that EN within 48 hours after gastrectomy can effectively improve the nutritional status of patients (39).…”

From prehab to rehab: Nutritional support for people undergoing pancreatic cancer surgery

“…The advice was tailored to the individual patient with the aim of providing 25-30 kcal kg -1 of energy and 1.2-1.5 g kg -1 of protein, as per European Society for Parenteral and Enteral Nutrition (ESPEN) guidelines. 38,39 The dietetic intervention consisted of: dietary modification (high energy/protein diet, little and often); oral nutritional supplements and enteral/parenteral nutrition if indicated and symptom control advice. All patients with pancreatic cancer were started on pancreatic enzyme replacement therapy.…”

Exploring complexities in nutritional support across the continuum of care

“…4 Changing operational procedures relating to oral feeding has led to improvements in length of hospital stay without detrimental effects, which have been observed in a number of different patient groups. 4 However, the exact timing of the introduction of an oral diet is still causing some uncertainty within the evidence base.…”

“…The effectiveness of early feeding in upper gastrointestinal patients compared to a more traditional approach has been reviewed and clinical endpoints, including complications, length of hospital stay and quality of life, have been assessed. 4 Changing operational procedures relating to oral feeding has led to improvements in length of hospital stay without detrimental effects, which have been observed in a number of different patient groups. 4 However, the exact timing of the introduction of an oral diet is still causing some uncertainty within the evidence base.…”

“…This is demonstrated from exemplars where strong links with operational procedures have resulted in positive effects with respect to clinical outcomes, hospital length of stay, anthropometry and resource utilisation. 4,6 Research has demonstrated that dietitians are effective patient advocates in interdisciplinary care systems and key players in clinical decision making at the forefront of directing for patients with differing disease states throughout the continuum of care.…”