Hypo-Calories with Micronutrients and Fat Emulsion of Pre-Operative Peripheral Parenteral Nutrition in Malnutrition Risk Rectal Cancer Patients: A Retrospective Cross-Sectional Study

Abstract

Malnutrition has been recognized as a significant risk factor for the post operated patients, especially for those patients undergoing abdominal operations. This study evaluated the effect of hypo-calories with micronutrients of pre-operative peripheral parenteral nutrition support (PPPN) for rectal cancer patients. Retrospective cross sectional study method was used to investigate. We screened rectal cancer patients past year pre-operative with malnutrition risk from our cancer database and divided into 2 groups, received or not received PPPN and compared the post-operative outcomes. The results showed that the post-operative serum albumin of the 25 patients received PPPN averaged 2.5 ± 0.32 g/dl; significantly better than those of the 15 patients not received PPPN (non-PPPN), which averaged 1.92 ± 0.42 g/dl. The first ambulatory time required 3.0 ± 0.8 days for the PPPN, significantly shorter than those for the non-PPPN, which averaged 4.9 ± 2.4 days. Post-operative hospital days for the patients received PPPN were 18.2 ± 10.5 day, also significantly fewer than the non-PPPN, which averaged 33.7 ± 20.0 day. More than 25% of the non-PPPN was infected with sepsis, while none was infected in the PPPN patients. In conclusion, this study verified the benefits of micronutrients of pre-operative peripheral parenteral nutrition support for rectal cancer patients.

Perioperative peripheral parenteral nutrition to support major gastrointestinal surgery: Expert opinion on treating the right patients at the right time

“…9. Summary and outlook: Improving nutritional support for patients undergoing major gastrointestinal surgery Improved awareness of the adverse impact of poor nutritional status as well as metabolic stress on patients undergoing major gastrointestinal surgery and the benefits of timely and appropriate nutrition support, which include shorter hospital stay, fewer complications and improved patient wellbeing, is warranted [dataset [57,59]]. Implementation of ERAS recommendations for perioperative nutritional support can help to optimize patient outcomes [dataset [34]].…”

Influence of Preoperative Peripheral Parenteral Nutrition with Micronutrients after Colorectal Cancer Patients

“…Our previous studies showed that the PPN with fat emulsion and micronutrients are convenient and effective nutritional support methods for surgical patients [ 17 ]. The extension studies suggested that supplying micronutrients can reduce postoperative inflammatory response for patients with preoperative malnutrition.…”

“…Peripheral parenteral nutrition (PPN) is easier to use and less risky than TPN; however, the PPN solutions that are generally used often do not provide enough energy and nutrients. Because more active nutritional support is essential to achieve complete nutrition and thereby improve patient tolerance and outcomes, modified PPN solutions have been tried and successfully applied [ 17 ]. Recently, combinations of two-in-one (dextrose + amino acids) formulas or fat emulsion with PPN have been commonly used.…”

Parenteral Nutrition Overview

“…Accordingly, PPN administration has been suggested as an ERAS intervention since it can facilitate the provision of timely nutrition support during the perioperative period in selected patients [ 47 , 49 ]. Accordingly, findings from small studies suggest that PPN is a feasible approach for providing nutritional support to selected patients in perioperative settings [ 138 , 139 , 140 , 141 ].…”