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perioperative nutritional support

Yu Ohkura, Shusuke Haruta, Tsuyoshi Tanaka, Masaki Ueno, Harushi Udagawa
BACKGROUND: We aimed to investigate the efficacy of postoperative early intervention with an elemental diet to reduce weight loss and enhance recovery after gastrectomy. Nutritional status and gastrointestinal immune function tend to worsen, and postoperative weight loss is inevitable in these patients; therefore, improvement in their postoperative condition is important, especially in gastric cancer patients aged ≥80 years. METHODS: Clinical outcomes and postoperative nutritional status were compared between 21 and 22 consecutive elderly patients aged ≥80 years who underwent distal gastrectomy before and after the introduction of postoperative oral elemental diet (Elental®, 300 kcal/day), respectively, between October 2011 and June 2016...
October 19, 2016: World Journal of Surgical Oncology
Alessandro Laviano, Gianluca Di Lazzaro Giraldi, Angela Koverech
PURPOSE OF REVIEW: Cachexia is a negative prognostic factor in cancer patients. The pathogenesis is related to a variable combination of reduced food intake and metabolic changes. However, whether nutritional support may contribute to effectively prevent and treat cachexia remains a debated issue. RECENT FINDINGS: Consistent evidence demonstrates that anabolic windows of opportunity occur during the clinical trajectory of cancer patients. Also, the use of specific nutrients, namely omega-3 fatty acids, may enhance the efficacy of nutritional support when tumor-driven inflammatory response is high...
October 7, 2016: Current Opinion in Supportive and Palliative Care
V Maňásek, K Bezděk, A Foltys, K Klos, J Smitka, D Smehlik
BACKGROUND: The primary objective of this study was to investigate the impact of high protein oral nutrition support (ONS) on clinical outcomes in patients with colorectal cancer (CRC). The secondary aim was to compare the cost of treatment and length of stay (LoS) for CRC patients taking high protein ONS vs. patients on conventional nutritional support. MATERIALS AND METHODS: The study was conducted on adult patients with CRC undergoing colorectal surgery. Informed consent was obtained before the study...
2016: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
Catalina Mosquera, Nicholas J Koutlas, Kimberly C Edwards, Ashley Strickland, Nasreen A Vohra, Emmanuel E Zervos, Timothy L Fitzgerald
BACKGROUND: The accurate diagnosis of malnutrition is imperative if we are to impact outcomes in the malnourished. The American Society of Parenteral and Enteral Nutrition (ASPEN) and Academy of Nutrition and Dietetics (AND), in an attempt to address this issue, have provided evidence-based criteria to diagnose malnutrition. The purpose of this study was to validate the ASPEN/AND criteria in a cohort of patients from a single high-volume surgical oncology unit. METHODS: Patients undergoing major abdominal surgery from June 2013 to March 2015 were classified by their nutritional status using the ASPEN/AND criteria...
September 2016: Journal of Surgical Research
Joseph A Molnar, Lucian G Vlad, Tuna Gumus
There is increasing awareness that chronic wound healing is very dependent on the patient's nutritional status, but there are no clearly established and accepted assessment protocols or interventions in clinical practice. Much of the data used as guidelines for chronic wound patients are extrapolated from acutely wounded trauma patients, but the 2 groups are very different patient populations. While most trauma patients are young, healthy, and well-nourished before injury, the chronic wound patient is usually old, with comorbidities and frequently malnourished...
September 2016: Plastic and Reconstructive Surgery
Alejandro A Floh, Julie Slicker, Steven M Schwartz
OBJECTIVES: The objectives of this review are to discuss the challenges of delivering adequate nutrition to children with congenital heart disease, including pre- and postoperative factors and the role of enteral and parenteral nutrition, as well as the evidence supporting current practices. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: Providing adequate nutritional support is paramount for critically ill infants with congenital heart disease, a population at particular risk for malnutrition...
August 2016: Pediatric Critical Care Medicine
Miao Liu, Zhen Zhu, Fang Lyu
Tumor patients are high-risk group of malnutrition, and the characteristics of pathophysiology of digestive tract tumor can aggravate the malnutrition, so the perioperative nutritional support should be planed and implemented for these patients. However, the understanding of nutritional support is still insufficient. Reducing preoperative fasting time, reasonable preoperative nutritional support, early postoperative enteral nutrition and multiple forms in combination are the optimal strategy of the perioperative nutritional treatment and management...
July 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Norimitsu Yabusaki, Tsutomu Fujii, Suguru Yamada, Kenta Murotani, Hiroyuki Sugimoto, Mitsuro Kanda, Goro Nakayama, Masahiko Koike, Michitaka Fujiwara, Yasuhiro Kodera
Recently, it has been reported that the relative dose intensity (RDI) of adjuvant chemotherapy (AC) influences survival in various cancers, but there are very few reports about RDI in pancreatic ductal adenocarcinoma (PDAC). The optimal timing for initiation of AC for PDAC also remains unknown. The aim of this study was to identify the significance of RDI and the time interval between surgery and initiation of AC on survival of patients with PDAC. Clinicopathological factors that affect RDI were also investigated...
July 2016: Medicine (Baltimore)
George I Mataliotakis, Athanasios I Tsirikos, Karen Pearson, Don S Urquhart, Carolyn Smith, Andrew Fall
Spinal deformity in patients with cystic fibrosis (CF) is usually mild requiring no treatment. These patients are rarely considered as surgical candidates for scoliosis correction, as the pulmonary condition and other comorbidities increase the risk of general anaesthesia and recovery. This paper reviews all the literature up to date with regard to scoliosis in patients with CF and reports this unique case of a 14-year-old Caucasian girl with progressive scoliosis, who was treated surgically at the age of 17...
2016: Case Reports in Orthopedics
Rosa Rosania, Costanza Chiapponi, Peter Malfertheiner, Marino Venerito
BACKGROUND: Nutritional management of patients with gastric cancer (GC) represents a challenge. SUMMARY: This review provides an overview of the present evidence on nutritional support in patients with GC undergoing surgery as well as in those with advanced disease. KEY MESSAGE: For patients undergoing surgery, the preoperative nutritional condition directly affects postoperative prognosis, overall survival and disease-specific survival. Perioperative nutritional support enriched with immune-stimulating nutrients reduces overall complications and hospital stay but not mortality after major elective gastrointestinal surgery...
May 2016: Gastrointestinal Tumors
Daniel Reim, Helmut Friess
BACKGROUND: Patients undergoing treatment for esophagogastric or esophageal cancer are exposed to a considerably high risk of malnutrition due to early obstruction of the gastrointestinal passage. Presently most of the patients undergo modern multimodal therapies which require chemoradiation or chemotherapy ahead of surgery. Therefore reconstruction of the obstructed gastrointestinal passage is considerably delayed. Surgery as the only curative option after neoadjuvant treatment is the mainstay of therapy in this setting...
May 2016: Gastrointestinal Tumors
C Dumont, D Lacrosse, Simonet, J L Schils, M de Kock
BACKGROUND: The anesthesiologist's involvement in perioperative medicine has significantly changed. In order to identify patients at risks of perioperative complications, the anesthesiologist has to consider, amongst others, screening and management of undernutrition. For this purpose knowledge of prevalence and risk factors, along with screening tools and guidelines for an adapted nutritional management and outcomes of renutrition are mandatory. The present review intends to provide these tools to the Anesthesiologists...
2016: Acta Anaesthesiologica Belgica
Fabian Grass, Michael Benoit, Pauline Coti Bertrand, Josep Sola, Markus Schäfer, Nicolas Demartines, Martin Hübner
BACKGROUND/AIMS: The aim of the current study was to assess the postoperative evolution of nutritional status and to relate it with postoperative outcomes. METHODS: Demographic, surgical and nutritional parameters were assessed 10 days preoperatively (d-10) and 30 days postoperatively (d30) in 146 patients. Risk factors responsible for perioperative (>5% between d-10 and d30) weight loss were identified. Overall, severe (Clavien 3-5) and infectious complications were compared in patients with and without perioperative weight loss (>5%)...
2016: Annals of Nutrition & Metabolism
Toshiaki Shichinohe, Takeshi Sasaki, Shuji Kitashiro, Takayuki Morita, Koichi Ono, Naoto Senmaru, Junichi Ikeda, Tetsufumi Kojima, Noriaki Kyogoku, Hidehisa Yamada, Nagato Sato, Kentaro Kato, Soichi Murakami, Yuma Ebihara, Yo Kurashima, Eiji Tamoto, Takehiro Noji, Toru Nakamura, Keisuke Okamura, Takahiro Tsuchikawa, Satoshi Hirano
PURPOSE: An amino acid-containing elemental diet (ED) does not require digestion for nutritional absorption, making it a good option for patients with gastrointestinal malabsorption. We conducted a randomized trial to confirm that perioperative ED enhanced the recovery of patients undergoing laparoscopic colectomy. METHODS: Patients in the intervention arm received commercially available ED from the day prior to surgery until postoperative day (POD) 3, whereas patients in the control group received a conventional perioperative diet program...
June 21, 2016: Surgery Today
T Paul Nickerson, Amit Merchea
The management of inflammatory bowel disease (IBD) is medically and surgically complex. Numerous patient- and disease-oriented factors must be considered in treating patients with IBD, including nutritional replenishment/support, effect of immunosuppressive medications, extent of resection, and use of proximal diversion. Perioperative planning and optimization of the patient is imperative to ensuring favorable outcomes and limiting morbidity. These perioperative considerations in Crohn disease and ulcerative colitis are reviewed here...
June 2016: Clinics in Colon and Rectal Surgery
Mary E Huerter, Eric J Charles, Emily A Downs, Yinin Hu, Christine L Lau, James M Isbell, Timothy L McMurry, Benjamin D Kozower
BACKGROUND: The nutritional status of esophageal cancer patients during neoadjuvant therapy remains a challenging problem. The objective of this study was to determine whether routine enteral feeding tube placement improved nutritional status and perioperative outcomes for patients undergoing neoadjuvant therapy for esophageal cancer. METHODS: The Society of Thoracic Surgeons database was used to identify patients who underwent neoadjuvant therapy and esophagectomy at our institution between 2010 and 2014...
September 2016: Annals of Thoracic Surgery
Ying-Jie Ma, Lian Liu, Jing Xiao, Bang-Wei Cao
This study was a systematic evaluation of the beneficial effects of n-3 polyunsaturated fatty acid (PUFA) in abdominal cancer surgical patients. A literature search of the databases PubMed, Medline, Cochrane, and EMBASE was conducted for studies published up to November 2014 in English language journals. Randomized controlled trials (RCTs) examining the effects of n-3 PUFA intake relative to conventional nutrition in surgical patients were included. The main outcomes were the duration of systemic inflammatory response syndrome (SIRS), length of hospital stay (LOS), serum C-reactive protein (CRP) levels, and postoperative complications...
May 2016: Nutrition and Cancer
Dongliang Li, Ming Wang, Jun Zhu, Shenwei Wu
OBJECTIVE: To explore the related factors of anastomotic leakfollowing anterior resection for the rectal cancer and the association of the preoperative nutritional risk screening 2002(NRS2002) score. METHODS: Clinical data of 396 rectal cancer patients who underwent elective anterior resection from January 2010 to July 2015 at Affiliated Lu'an Hospital of Anhui Medical University were collected. Patient's nutritional risk score on admission was calculated by NRS2002 scoring system according to original medical records...
April 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Shishira Bharadwaj, Brandon Trivax, Parul Tandon, Bilal Alkam, Ibrahim Hanouneh, Ezra Steiger
Postoperative infectious complications are independently associated with increased hospital length of stay (LOS) and cost and contribute to significant inpatient morbidity. Many strategies such as avoidance of long periods of preoperative fasting, re-establishment of oral feeding as early as possible after surgery, metabolic control and early mobilization have been used to either prevent or reduce the incidence of postoperative infections. Despite these efforts, it remains a big challenge to our current healthcare system to mitigate the cost of postoperative morbidity...
May 2016: Gastroenterology Report
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