Perioperative Artificial Enteral Nutrition in Malnourished Esophageal and Stomach Cancer Patients and Its Impact on Postoperative Complications

Abstract

Cancer is responsible for approximately 13% of all causes of death worldwide, and 20% of cancer patients die because of malnutrition and its complications. Malnutrition is common in cancer of stomach and esophagus. Although it is widely accepted that malnutrition adversely affects the postoperative outcome of patients, there is little evidence that perioperative nutrition support can reduce surgical risk in malnourished cancer patients. This prospective study was carried out from December 2016 to July 2017 at the Kidwai Memorial Institute of Oncology, Bengaluru. After stratified for age, sex, and tumor localization, patients were selected non-randomly and assigned to study (n = 30, 14 women, 16 men) and control group (n = 30, 14 women, 16 men) as alternate patients. Within 48 h of admission, patients underwent nutritional assessment by the subjective global assessment. Perioperative nutrition was administered in the study group by enteral route only. Patients had a functioning gastrointestinal tract, and they received enteral nutrition (EN). Target intake of non-protein (25 kcal/kg per day) and protein (0.25 g nitrogen/kg per day) was provided using available enteral formulas. This was supplementary to standard hospital diet. Nutritional reassessment after 15 days of intervention showed significant change in nutritional status, which was measured as gain in weight for each patient. There were significant differences in the mortality and complications between the two groups. The total length of hospitalization and postoperative stay of the control patients were significantly longer than those of the study patients. In conclusion, perioperative nutrition support can decrease the incidence of postoperative complications in moderately and severely malnourished gastric and esophageal cancer patients. In addition, it is effective in reducing mortality. Enteral nutrition support alone can be used in the management of malnourished patients undergoing gastric and esophageal surgery.

Sarcopenia in Patients With Normal Body Mass Index Is an Independent Predictor for Postoperative Complication and Long‐Term Survival in Gastric Cancer

“…A large number of patients with GC suffer from malnutrition due to cancer cachexia and digestion disorders. Pre‐operative malnutrition has been reported to be closely related to postoperative complications 24 and long‐term survival of patients with GC 25 . Therefore, increasing pre‐operative nutrition risk screening indicators were used to predict the clinical outcome of such patients.…”

Assessment of nutritional status using objective and subjective methods in Greek patients with cancer

“…Malnutrition is a predictor of life expectancy, as it is estimated to be the cause of death in 20% of original report cancer patients [3]. Early nutritional assessment and dietary intervention may reduce mortality and morbidity in patients with cancer [4].…”

Effect of HCH Nutrition Management Combined with Early Exercise Nursing on Nutrition Status and Postoperative Rehabilitation of Patients after Gastric Cancer Surgery

“…As a common tumor of the digestive system, gastric cancer ranks second in morbidity and mortality among all malignant tumors in China. Malnutrition is common in patients with gastric cancer due to the tumor itself and gastrectomy [ 1 ]. According to incomplete statistics, 48% of newly diagnosed tumor patients suffer from severe malnutrition, and 17% suffer from mild to moderate malnutrition [ 2 ].…”