Oral Nutritional Supplements and Enteral Nutrition in Patients with Gastrointestinal Surgery

Wobith, Maria; Weimann, Arved

doi:10.3390/nu13082655

Cited by 37 publications

(28 citation statements)

References 71 publications

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“…Gastrointestinal diseases (especially tumors) are becoming common yearly, thus seriously threatening the health and quality of life of many patients and burdening families and the whole society[ 1 , 2 ]. Gastrointestinal surgery is a complicated process used to treat many gastrointestinal diseases and is associated with large trauma.…”

Section: Introductionmentioning

confidence: 99%

Nutritional status efficacy of early nutritional support in gastrointestinal care: A systematic review and meta-analysis

He¹,

Liu²,

He³

et al. 2023

World J Gastrointest Surg

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BACKGROUND Gastrointestinal surgery is a complicated process used to treat many gastrointestinal diseases, and it is associated with a large trauma: Most patients often have different degrees of malnutrition and immune dysfunction before surgery and are prone to various infectious complications during postoperative recovery, thus affecting the efficacy of surgical treatment. Therefore, early postoperative nutritional support can provide essential nutritional supply, restore the intestinal barrier and reduce complication occurrence. However, different studies have shown different conclusions. AIM To assess whether early postoperative nutritional support can improve the nutritional status of patients based on literature search and meta-analysis. METHODS Articles comparing the effect of early nutritional support and delayed nutritional support were retrieved from PubMed, EMBASE, Springer Link, Ovid, China National Knowledge Infrastructure, China Biology Medicine databases. Notably, only randomized controlled trial articles were retrieved from the databases (from establishment date to October 2022). The risk of bias of the included articles was determined using Cochrane Risk of Bias V2.0. The outcome indicators, such as albumin, prealbumin, and total protein, after statistical intervention were combined. RESULTS Fourteen literatures with 2145 adult patients undergoing gastrointestinal surgery (1138 patients (53.1%) receiving early postoperative nutritional support and 1007 patients (46.9%) receiving traditional nutritional support or delayed nutritional support) were included in this study. Seven of the 14 studies assessed early enteral nutrition while the other seven studies assessed early oral feeding. Furthermore, six literatures had "some risk of bias," and eight literatures had "low risk". The overall quality of the included studies was good. Meta-analysis showed that patients receiving early nutritional support had slightly higher serum albumin levels, than patients receiving delayed nutritional support [MD (mean difference) = 3.51, 95%CI: -0.05 to 7.07, Z = 1.93, P = 0.05]. Also, patients receiving early nutritional support had shorter hospital stay (MD = -2.29, 95%CI: -2.89 to -1.69), Z = -7.46, P < 0.0001) shorter first defecation time (MD = -1.00, 95%CI: -1.37 to -0.64), Z = -5.42, P < 0.0001), and fewer complications (Odd ratio = 0.61, 95%CI: 0.50 to 0.76, Z = -4.52, P < 0.0001) than patients receiving delayed nutritional support. CONCLUSION Early enteral nutritional support can slightly shorten the defecation time and overall hospital stay, reduce complication incidence, and accelerate the rehabilitation process of patients undergoing gastrointestinal surgery. ...

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Section: Introductionmentioning

confidence: 99%

Nutritional status efficacy of early nutritional support in gastrointestinal care: A systematic review and meta-analysis

He¹,

Liu²,

He³

et al. 2023

World J Gastrointest Surg

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“…In particular, the strategy of combining enteral and parenteral nutrition provided essential nutritional support for patients, facilitating intestinal recovery, enhancing immunity, and improving lung function. [22–24] This is supported by the reduction in PG-SGA scores and increases in PA, ALB, and Hb levels, underscoring the significance of nutritional interventions in promoting postoperative recovery.…”

Section: Discussionmentioning

confidence: 92%

Effectiveness of an ERAS-based exercise-nutrition management model in enhancing postoperative recovery for thoracoscopic radical resection of lung cancer: A randomized controlled trial

Huang,

Hu,

Chen

2024

Medicine

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Background: To analyze the effect of an exercise-nutrition management model based on the Enhanced Recovery After Surgery (ERAS) concept on patients undergoing thoracoscopic radical surgery for lung cancer. Methods: From June 2019 to December 2022, 85 lung cancer patients who underwent thoracoscopic radical lung cancer surgery were randomly divided into 2 groups. The control group, consisting of 42 patients, received routine nursing care during the perioperative period. The study group, comprising 43 patients, implemented an exercise-nutrition management model based on the ERAS concept during the perioperative period. We compared general data, perioperative indicators, compliance, and complications between the 2 groups. Additionally, we assessed the nutritional status using the patient-generated subjective global assessment (PG-SGA), albumin (ALB), prealbumin (PA), and hemoglobin (Hb), as well as lung function, including forced expiratory volume in the first second (FEV1) and maximum voluntary ventilation (MVV), in the patient population following the Piper intervention. Results: In the study group, the times to first defecation and getting out of bed, the duration of thoracic drainage tube indwelling, and the length of hospital stay were shorter than those in the control group. The VAS scores on the 2nd and 3rd postoperative days were lower in the study group than in the control group (P < .05). Medication compliance was higher in the study group compared to the control group (P < .05). Post-intervention, the PG-SGA scores in the study group were lower, while PA, ALB, and Hb levels were higher than those in the control group (P < .05). The MVV, FEV1, and FVC values were higher in the study group than in the control group after the intervention (P < .05). The PFS and mMRC scores were lower in the study group compared to the control group after the intervention, and the QLQ-C30 scores were higher (P < .05). The incidence of complications was 6.98% in the study group, which was not significantly different from 11.90% in the control group (P > .05). Conclusion: The exercise-nutrition management model, based on the ERAS concept, exhibits significant perioperative effects in patients undergoing thoracoscopic radical resection of lung cancer, improving their nutritional status and reducing complications.

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“…Nearly 50% of hospitalized patients are malnourished or at risk of malnutrition, and hospitalized and surgical patients who are malnourished have significantly worse clinical outcomes ( 34 ). Screening for malnutrition before major surgery is essential because it can identify patients at risk of malnutrition who may benefit from preoperative nutritional intervention ( 35 ), which can improve patient outcomes ( 36 ). This study shows that preoperative PNI and TBIL levels were independent risk factors for short-term postoperative complications of dCCA.…”

Section: Discussionmentioning

confidence: 99%

Preoperative prognostic nutritional index predicts short-term complications after radical resection of distal cholangiocarcinoma

Liu

et al. 2023

Front. Surg.

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BackgroundThe occurrence of postoperative complications of distal cholangiocarcinoma (dCCA) is an indicator of poor patient prognosis. This study aimed to determine the immune-nutritional indexes (INIs) that can predict short-term postoperative complications.MethodsA retrospective analysis of 148 patients with dCCA who were operated radical pancreaticoduodenectomy at the First Hospital of Lanzhou University from December 2015 to March 2022 was conducted to assess the predictive value of preoperative INIs and preoperative laboratory tests for short-term postoperative complications, and a decision tree model was developed using classification and regression tree (CART) analysis to identify subgroups at risk for overall complications.ResultsIn this study, 83 patients (56.08%) experienced overall complications. Clavien-Dindo grade III-V complications occurred in 20 patients (13.51%), and 2 patients died. The areas under curves (AUCs) of the preoperative prognostic nutritional index (PNI), controlling nutritional status (CONUT) score, and neutrophil-to-lymphocyte ratio (NLR) were compared; the PNI provided the maximum discrimination for complications (AUC = 0.685, 95% CI = 0.600–0.770), with an optimal cutoff value of 46.9, and the PNI ≤ 46.9 group had higher incidences of overall complications (70.67% vs. 40.00%, P < 0.001) and infectious complications (28.77% vs. 13.33%, P = 0.035). Multivariate logistic regression analysis identified PNI (OR = 0.87, 95% CI: 0.80–0.94) and total bilirubin (OR = 1.01, 95% CI: 1.00–1.01) were independent risk factors for overall complications (P < 0.05). According to CART analysis, PNI was the most important parameter, followed by the total bilirubin (TBIL) level. Patients with a PNI lower than the critical value and TBIL higher than the critical value had the highest overall complication rate (90.24%); the risk prediction model had an AUC of 0.714 (95% CI, 0.640–0.789) and could be used to stratify the risk of overall complications and predict grade I-II complications (P < 0.05).ConclusionThe preoperative PNI is a good predictor for short-term complications after the radical resection of dCCA. The decision tree model makes PNI and TBIL easier to use in clinical practice.

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Oral Nutritional Supplements and Enteral Nutrition in Patients with Gastrointestinal Surgery

Cited by 37 publications

References 71 publications

Nutritional status efficacy of early nutritional support in gastrointestinal care: A systematic review and meta-analysis

Nutritional status efficacy of early nutritional support in gastrointestinal care: A systematic review and meta-analysis

Effectiveness of an ERAS-based exercise-nutrition management model in enhancing postoperative recovery for thoracoscopic radical resection of lung cancer: A randomized controlled trial

Preoperative prognostic nutritional index predicts short-term complications after radical resection of distal cholangiocarcinoma

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