[Early results of esophagectomy and total or proximal gastrectomy without perioperative administration of total parenteral nutrition].
The aim of the study was to analyse complications after radical oesophagectomy or gastrectomy in cancer patients without administration of total parental nutrition (TPN).


METHODS
45 consecutive patients underwent oesophagectomy (8 patients), proximal subtotal gastrectomy (10 patients) and total gastrectomy (27 patients). Stapler sutures were used to create anastomoses between oesophagus and stomach or oesophagus and jejunum. None patient received TPN. In all patients antropometrical and biochemical characteristics were assessed. Preoperative risk factors and type of complications were estimated. Patients with surgical complications were compared with patients without surgical complications using anthropometric and biochemical values.


RESULTS
Surgical complications occurred in 10(22%) patients. The most common complication was postoperative wound infection (6 patients). Anastomotic dehiscence occurred in 4 patients and resulted in 2 deaths. Complications and deaths were observed more frequently in severely malnourished patients (BMI < 18).


CONCLUSIONS
There is no justification for routine perioperative use of TPN in patients without severe malnutrition undergoing oesophageal or gastric surgery for cancer.
Komorowski
Andrzej L
AL
Kliniki Chirurgii Onkologicznej Centrum Onkologii-Instytutu im. M. Skłodowskiej - Curie Oddział w Krakowie.
Łobaziewicz
Wojciech
W
Kołodziejski
Leszek
L
Duda
Krzysztof
K
Darasz
Zbigniew
Z
D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000150:complications / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome