Results of a survey on peri-operative nutritional support in pancreatic and biliary surgery in Spain

Segurola, Carmelo Loinaz; Cerdán, Federico Ochando; López, E. Vicente; Requejo, Alejandro; Cillero, Pedro López; Bravo, Miguel Ángel Gómez; Prous, J. Fabregat; Pérez, E. Varo; León, A. Miyar de; Fondevila, Constantino; López, Andrés Valdivieso; Blanco‐Fernández, Gerardo; Sánchez, Belinda; Andújar, Rafael López; Suárez, Yilian Fundora; Andorrà, Esteban Cugat; Valladares, Luis Díez; Cabezón, Javier Herrera; Gil, Agustín García; Morales-Soriano, Rafael; Sánchez, Fernando Pardo; Ortí, Luis Sabater; Baena, José Ángel López; Muñoz-Bellvis, Luís; Pérez, Elena Martín; Saborido, B. Perez; Muñóz, Miguel Ángel Suárez; Día, Juan Carlos Meneu; Quer, Maite Albiol; Dehesa, A. Sanjuanbenito; Ángel, José; Pérez, Fernando Pereira; Crespo, G.; Sánchez, Juan C.; Sanz, Miguel León

doi:10.20960/nh.02895

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…Malnutrition has a definitive impact on several aspects of cancer treatment and outcome, reducing dose intensity and treatment response, increasing treatment toxicities, worsening patient's quality of life and functionality, with weight loss and loss of skeletal muscle mass as two hallmarks of cachexia in advanced cancer patients [17]. Despite strong recommendations from clinical practice guidelines regarding the integration of nutrition into the overall management of surgical and cancer patients [18][19][20], as well as awareness of surgeons that nutrition intervention can reduce postoperative complications and improve outcome [21,22], perioperative nutrition practices continue to be suboptimal in daily clinical routine [23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Impact of Nutritional Risk and Malnutrition in Gastrointestinal Surgical Oncology Patients: A Prospective, Observational, Multicenter and Exploratory Study

Póveda¹,

Suárez-de-la-Rica²,

Cáncer-Minchot³

et al. 2023

Preprint

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A prospective, observational, multicenter, and exploratory study was conducted in 469 gastrointestinal cancer patients undergoing elective surgery. The Malnutrition Universal Screening Tool (MUST) and the Global Leadership Initiative on Malnutrition (GLIM) criteria were used to assess nutritional risk. On admission, 17.9% and 21.1% of patients were at moderate (MUST score 1) and severe (MUST score ≥ 2) nutritional risk, respectively. GLIM criteria used in patients with MUST score ≥ 2 showed moderate malnutrition in 35.3% of patients and severe in 64.6%. Forty-seven percent of patients with MUST score ≥ 2 on admission had the same score at discharge, and 20.7% with MUST score 0 had moderate/severe risk at discharge. Small bowel, esophageal and gastric cancer, and diabetes were predictors of malnutrition on admission. Complications were significantly higher among patients with MUST score 1 or ≥ 2 either on admission (p = 0.001) or at discharge (p &lt; 0.0001). In patients who received nutritional therapy (n = 231), 43% continued to have moderate/severe nutritional risk on discharge, and 54% of those with MUST ≥ 2 on admission maintained this score at discharge. In gastrointestinal cancer patients undergoing elective surgery, there is an urgent need for improving nutritional risk screening before and after surgery, as well as improving nutritional therapy during hospitalization

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Section: Introductionmentioning

confidence: 99%

Prevalence and Impact of Nutritional Risk and Malnutrition in Gastrointestinal Surgical Oncology Patients: A Prospective, Observational, Multicenter and Exploratory Study

Póveda¹,

Suárez-de-la-Rica²,

Cáncer-Minchot³

et al. 2023

Preprint

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show abstract

“…Indeed, early EN has been shown to correlate with reduced length of hospital stay and reduced rates of delayed gastric emptying (DGE) [ 4 , 5 ]. However, the nutritional management of PD patients is known to be highly variable [ 6 - 8 ], and some centers still routinely provide parenteral nutrition (PN). A proportion of patients who receive PN experience serious complications [ 9 ], so it should only be provided when there is a clear indication.…”

Section: Introductionmentioning

confidence: 99%

Do some patients receive unnecessary parenteral nutrition after pancreatoduodenectomy? Results from an international multicentre study

Russell,

Labib,

Murphy

et al. 2023

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes. Methods Data were extracted from the Recurrence After Whipple’s study, a retrospective multicenter study of PD outcomes. Results In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was “enteral only,” “parenteral only,” and “enteral and parenteral” in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m 2 ( p = 0.03), absence of preoperative biliary stenting ( p = 0.009), and serum albumin < 36 g/L ( p = 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN. Conclusions A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes.

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“…Malnutrition has a definitive impact on several aspects of cancer treatment and outcome, reducing dose intensity and treatment response, increasing treatment toxicities, and worsening the patient’s quality of life and functionality, with weight loss and loss of skeletal muscle mass as two hallmarks of cachexia in advanced cancer patients [ 17 ]. Despite strong recommendations from clinical practice guidelines regarding the integration of nutrition into the overall management of surgical and cancer patients [ 18 , 19 , 20 ], as well as awareness of surgeons that nutrition intervention can reduce postoperative complications and improve outcome [ 21 , 22 ], perioperative nutrition practices continue to be suboptimal in daily clinical routine [ 23 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

The Prevalence and Impact of Nutritional Risk and Malnutrition in Gastrointestinal Surgical Oncology Patients: A Prospective, Observational, Multicenter, and Exploratory Study

et al. 2023

View full text Add to dashboard Cite

A prospective, observational, multicenter, and exploratory study was conducted in 469 gastrointestinal cancer patients undergoing elective surgery. The Malnutrition Universal Screening Tool (MUST) and the Global Leadership Initiative on Malnutrition (GLIM) criteria were used to assess nutritional risk. On admission, 17.9% and 21.1% of patients were at moderate (MUST score 1) and severe (MUST score ≥ 2) nutritional risk, respectively. The GLIM criteria used in patients with a MUST score ≥ 2 showed moderate malnutrition in 35.3% of patients and severe in 64.6%. Forty-seven percent of patients with a MUST score ≥ 2 on admission had the same score at discharge, and 20.7% with a MUST score 0 had moderate/severe risk at discharge. Small bowel, esophageal, and gastric cancer and diabetes were predictors of malnutrition on admission. Complications were significantly higher among patients with a MUST score 1 or ≥2 either on admission (p = 0.001) or at discharge (p < 0.0001). In patients who received nutritional therapy (n = 231), 43% continued to have moderate/severe nutritional risk on discharge, and 54% of those with MUST ≥ 2 on admission maintained this score at discharge. In gastrointestinal cancer patients undergoing elective surgery, there is an urgent need for improving nutritional risk screening before and after surgery, as well as improving nutritional therapy during hospitalization.

show abstract

Results of a survey on peri-operative nutritional support in pancreatic and biliary surgery in Spain

Abstract: Results of a survey on peri-operative nutritional support in pancreatic and biliary surgery in Spain Resultados de una encuesta sobre el soporte nutricional perioperatorio en la cirugía pancreática y biliar en España

Cited by 4 publications

References 14 publications

Prevalence and Impact of Nutritional Risk and Malnutrition in Gastrointestinal Surgical Oncology Patients: A Prospective, Observational, Multicenter and Exploratory Study

Prevalence and Impact of Nutritional Risk and Malnutrition in Gastrointestinal Surgical Oncology Patients: A Prospective, Observational, Multicenter and Exploratory Study

Do some patients receive unnecessary parenteral nutrition after pancreatoduodenectomy? Results from an international multicentre study

The Prevalence and Impact of Nutritional Risk and Malnutrition in Gastrointestinal Surgical Oncology Patients: A Prospective, Observational, Multicenter, and Exploratory Study

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