Knowledge and Practices of Digestive Surgeons concerning Specialized Nutritional Support in Cancer Patients: A Survey Study

Abstract

A survey study based on a 21-item questionnaire was conducted to assess knowledge and practices of digestive surgeons focused on nutritional support in gastrointestinal cancer patients. At least 5 staff digestive surgeons from 25 tertiary care hospitals throughout Spain were invited to participate and 116 accepted. Malnutrition was correctly defined by 81.9% of participants. In patients undergoing major abdominal surgery, 55.2% considered that preoperative nutritional support is indicated in all patients with malnutrition for a period of 7–14 days. For the diagnosis of malnutrition, only 18.1% of participants selected unintentional weight loss together with a fasting or semi-fasting period of more than one week. Regarding the advantages of enteral infusion, 93.7% of participants considered preservation of the integrity of the intestinal mucosa and barrier function, and in relation to peripheral parenteral nutrition, 86.2% selected the definition of nutrient infusion through a peripheral vein and 81.9% its indication for less than 7 days. Digestive surgeons had a limited knowledge of basic aspects of clinical nutrition in cancer patients, but there was some variability regarding clinical practice in individual cases. These findings indicate the need to develop standardized clinical protocols as well as a national consensus on nutrition support in cancer patients.

Are Guideline Recommendations on Supportive Nutrition and Exercise Therapy for Cancer Patients Implemented in Clinical Routine? A National Survey with Real-Life Data

“…A national, representative, cross-sectional survey from China (1732 participants from 51 clinics/hospitals) identified the lack of education and training of healthcare staff in the use of clinical guidelines as a key barrier to guideline implementation, while experience with evidence-based medicine in education and practice was significantly associated with self-reported guideline adherence [ 34 ]. Durán-Poveda et al also confirmed in their survey that there is little knowledge among medical staff about nutritional guidelines and that, therefore, evidence-based nutrition therapy can be offered to cancer patients far too seldom [ 35 ]. Better education and further training of healthcare staff might, therefore, be an important target point to optimize guideline implementation in clinical practice.…”

The Impact of NUTRItional Status at First Medical Oncology Visit on Clinical Outcomes: The NUTRIONCO Study

“…However, the answers to the survey highlighted that nutritional support is not yet fully managed consistently with the available guidelines. Finally, a survey based on a 21-item questionnaire highlighted that digestive surgeons have a limited knowledge of basic aspects of clinical nutrition in gastrointestinal cancer patients, even if with some variability regarding the clinical practice in individual cases [ 28 ].…”

Effect of comfort nursing in the perioperative period of free flap transplantation to repair the defects after surgery for malignant head and neck tumors

“…Malnutrition is a common problem in patients with cancer and is associated with increased risk of complications and reduced tolerance of anti-cancer treatment. [ 26 , 27 ] Previous studies have also shown that comfort nursing can significantly reduce the incidence of postoperative complications, improve the safety of surgical treatment, and reduce anxiety and depression in patients. [ 12 , 13 ] These results consistent with our findings.…”