Perioperative artificial nutrition in malnourished gastrointestinal cancer patients.
OBJECTIVE
To investigate the potential role of perioperative nutrition in reducing complications and mortality in malnourished gastrointestinal cancer patients.


METHODS
Four hundred and sixty-eight elective moderately or severely malnourished surgical patients with gastric or colorectal cancers defined by the subjective global assessment (SGA) were randomly assigned to 7 d preoperative and 7 d postoperative parenteral or enteral nutrition vs a simple control group. The nutrition regimen included 24.6+/-5.2 kcal /kg per d non-protein and 0.23+/-0.04 g nitrogen /kg per d. Control patients did not receive preoperative nutrition but received 600+/-100 kcal non-protein plus or not plus 62+/-16 g crystalline amino acids postoperatively.


RESULTS
Complications occurred in 18.3% of the patients receiving nutrition and in 33.5% of the control patients (P=0.012). Fourteen patients died in the control group and 5 in those receiving nutrition. There were significant differences in the mortality between the two groups (2.1% vs 6.0%, P=0.003). The total length of hospitalization and postoperative stay of control patients were significantly longer (29 vs 22 d, P=0.014) than those of the studied patients (23 vs 12 d, P=0.000).


CONCLUSIONS
Perioperative nutrition support is beneficial for moderately or severely malnourished gastrointestinal cancer patients and can reduce surgical complications and mortality.
Wu
Guo-Hao
GH
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China. wugh@zshospital.net
Liu
Zhong-Hua
ZH
Wu
Zhao-Han
ZH
Wu
Zhao-Guang
ZG