Effectiveness of intensive perioperative nutrition therapy among adults undergoing gastrointestinal and oncological surgery in a public hospital: study protocol for a pragmatic randomized control trial

Abstract

Background Perioperative malnutrition is common in patients undergoing gastrointestinal-oncology surgery and is associated with longer hospital stays, increased postoperative complications, poorer quality of life, and lower survival rates. Current practice emphasizes the role of early perioperative nutrition therapy as an early intervention to combat the postoperative complications of patients and the implementation is now widely adopted. However, there is still a lack of research on determining the effectiveness of intensive nutrition therapy and providing ONS perioperative locally. This becomes the significance of this study and serves as a basis for management and guideline in the local hospital settings. Methods This is a pragmatic randomized control trial study where elective admitted patients will be randomly divided into the intervention (SS) or control (NN) group. All data will be collected during a face-to-face interview, anthropometric measurement, blood sampling (albumin, white blood count, hemoglobin, and c-reactive protein), handgrip strength, and postoperative complications. Group SS will be receiving a tailored lifestyle and intensively supplemented with oral nutrition support as compared to Group NN that will receive standard medical care. The primary outcome for this study is the length of stay in the hospital. Additional outcome measures are changes in biochemical profile and nutritional and functional status. The effects of intervention between groups on the outcome parameters will be analyzed by using the SPSS General Linear Model (GLM) for the repeated measure procedure. Discussion The intervention implemented in this study will serve as baseline data in providing appropriate nutritional management in patients undergoing gastrointestinal and oncological surgery. Trial registration ClinicalTrials.gov Protocol Registration and Results System (PRS) NCT04347772. Registered on 20 November 2019.

Current Oncology Nutrition Care Practice in Southeast Asia: A Scoping Review

“…Characteristics of the 18 studies are summarized in Table 2 [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]. Studies were published between 2012-2022 from five of 11 countries (45%) listed in Southeast Asia: Malaysia (n = 10, 56%) [32,[37][38][39][40][41]44,[47][48][49], Vietnam (n = 4, 22%) [33,35,36,42], Philippines (n = 2, 11%) [45,46], Singapore [34] and Thailand [43] (both n = 1, 6%). Half of the studies [32,[38][39][40]42,[45][46][47][48] were published in 2020 or later, while the remaining studies were published from 2012-2019 [33][34][35]…”

“…Studies were published between 2012-2022 from five of 11 countries (45%) listed in Southeast Asia: Malaysia (n = 10, 56%) [32,[37][38][39][40][41]44,[47][48][49], Vietnam (n = 4, 22%) [33,35,36,42], Philippines (n = 2, 11%) [45,46], Singapore [34] and Thailand [43] (both n = 1, 6%). Half of the studies [32,[38][39][40]42,[45][46][47][48] were published in 2020 or later, while the remaining studies were published from 2012-2019 [33][34][35][36][37]41,43,44,49]. Nine studies used observational study design, with most (n = 7) undertaken as a prospective observational study [35,36,38,41,43,44,46], retrospective [33] or prospective cohort [40].…”

“…Nine studies used observational study design, with most (n = 7) undertaken as a prospective observational study [35,36,38,41,43,44,46], retrospective [33] or prospective cohort [40]. The remaining studies were audits [34,37], study protocols [32,47], randomized controlled trials (RCT) [48,49], qualitative studies [39,45], and a quasi-experimental study [42].…”

“…In 16 studies (89%) [32][33][34][35][36][38][39][40][41][42][43][44][46][47][48][49], participants were patients with cancer, while in two studies (11%), participants were a mix of patients and health professionals; the health professionals were nurses and medical professionals in one study [37], and nurses, nutritionists and dietitians, oncologists, study coordinators, and surgeons in the other study [45].…”

“…Three studies involved two cancer types [42,47,48]. In comparison, four studies involved cancer of a particular region, i.e., head and neck cancer (n = 1) [38], hematological malignancies (n = 1) [34], gastrointestinal cancer (n = 2) [32,33], while two studies examined newly diagnosed cancer patients, with all cancer types eligible to participate [41,44]. Four studies did not detail the cancer type of patients [35][36][37]45].…”