Preoperative Parenteral Feeding in Patients With Gastrointestinal Carcinoma

Müller, Jochen; Dienst, C.; Brenner, U.; Pichlmaier, H.

doi:10.1016/s0140-6736(82)90212-4

Cited by 437 publications

(75 citation statements)

References 6 publications

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“…Those studies that did indicate benefits from PN tended to include heterogeneous populations 43,45 that consisted of both malnourished and well nourished patients. Unfortu nately, some studies reporting benefits also had faulty study designs.…”

Section: Practice Guidelines and Rationalesmentioning

confidence: 99%

A.S.P.E.N. Clinical Guidelines: Nutrition Support Therapy During Adult Anticancer Treatment and in Hematopoietic Cell Transplantation

August

Huhmann

2009

J Parenter Enteral Nutr

421

279

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Section: Practice Guidelines and Rationalesmentioning

confidence: 99%

A.S.P.E.N. Clinical Guidelines: Nutrition Support Therapy During Adult Anticancer Treatment and in Hematopoietic Cell Transplantation

August

Huhmann

2009

J Parenter Enteral Nutr

421

279

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“…Most of the published information relating to the supposed beneficial effects of TPN as an adjunct to surgery or chemotherapy for malignant disease have concentrated on the immediate peritherapeutic period with no regard for the long-term outcome (Copeland et al 1977;Heatley et al 1979;Muller et al 1982). More recently, several clinical studies have suggested that in fact the prognosis may be worse in parenterally-fed patients for reasons unrelated simply to the presence of a central venous feeding catheter.…”

Section: Effects Of Lipid Emulsions On Lymphocyte Functionmentioning

confidence: 99%

The effects of lipids on some aspects of the cellular immune response

Guillou

1993

Proc. Nutr. Soc.

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“…Two previously published analyses have suggested that PNS would save money, 44 at least under certain circumstances. 49 One study 44 employed ef®cacy data from only the most favourable trial 50 to draw their conclusions. The other study used hypothetical ef®ca-cies, and noted that the calculations were very sensitive to the assumptions being made regarding ef®cacy.…”

Section: ±19mentioning

confidence: 99%

Nutritional support

Ofman

Koretz

1997

Aliment Pharmacol Ther

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Nutritional support currently accounts for about 1% of the total health care costs in the USA. Interestingly, most of the prospective randomized controlled trials to date have not been able to demonstrate that this therapeutic intervention alters morbidity or mortality. In fact, parenteral nutritional support may predispose the recipients to developing systemic infections. There have been a few areas in which nutritional support may be of benefit. Enteral supplements given to underweight women who suffer hip fractures reduce the hospital stay and, presumably, overall cost. Preoper‐ative parenteral nutritional support may produce a small absolute reduction in post‐operative morbidity, but its cost becomes prohibitive. Preoperative enteral nutritional support, especially if carried out in the home, may be of benefit (using the most optimistic interpretation of a small number of trials); if so, it is an economically defensible intervention. Particular nutrients or diets may have specific effects on certain disease processes. Indirect comparisons have suggested that elemental diets can be used to treat flares of Crohn's disease (perhaps because putative food antigens are removed). However, corticosteroid therapy is more efficacious. Furthermore, it is less expensive to employ 6‐mercaptopurine as the next modality in steroid failures. Branched‐chain amino acid infusions may have some effect on hepatic encephalopathy, but again, lactulose is less expensive. Nutritional support is one area of medicine in which there has been far more enthusiasm than the data justify. Disease‐associated malnutrition probably is a secondary phenomenon, not an important cause of morbidity. The widespread use of this modality cannot be justified in a cost‐constrained health care system.

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Preoperative Parenteral Feeding in Patients With Gastrointestinal Carcinoma

Cited by 437 publications

References 6 publications

A.S.P.E.N. Clinical Guidelines: Nutrition Support Therapy During Adult Anticancer Treatment and in Hematopoietic Cell Transplantation

A.S.P.E.N. Clinical Guidelines: Nutrition Support Therapy During Adult Anticancer Treatment and in Hematopoietic Cell Transplantation

The effects of lipids on some aspects of the cellular immune response

Nutritional support

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