title: [Evaluation of perioperative nutritional therapy in patients with gastrointestinal tract neoplasms].
abstract: OBJECTIVE
  Cancer is usually associated to an important level of desnutrition together with a postoperative morbidity and mortality increase. The purpose of this study was evaluating its efficacy perioperative nutritional support to reduce surgical complications, stances and mortality significantly in patients undergoing higher digestive tract procedures.
  
  
  METHODS
  A prospective, randomized trial was done among a sample of neoplasic patients undergoing higher intestinal tract resective surgery during a period of 4 years. After a nutritional assessment, a perioperative immune-enhancing formula was randomly assigned to a group of patients who presented malnourished preoperatively (DS) while well-nourished and the rest of malnourished patients (DNS) received pre-surgical dietetic guidance and intravenous fluids after surgery until the reintroduction of normal diet. The variables studied were: age, sex, tumor stage and length of hospital stay. Nutritional status at admission and discharge, mortality, outcome from surgery and gastrointestinal side effects (tolerability, diarrhoea, vomits or distension) were also collected. Statistical analyses were performed with the with the chi2 for qualitative variables, ANOVA and the Turkey post-hoc tests for the quantitative ones, with a significance of 95%.
  
  
  RESULTS
  Sample conformed by 50 patients in 3 groups that were compared for all baseline and surgical characteristics. Significant differences were observed in the incidence of gastrointestinal and infectius complications with better progress in DS group. It was obtained a reduction in the length of hospital stay in 12.29 days in DS group in contrast to DNS group (P=0.224).
  
  
  CONCLUSIONS
  Significant benefit from perioperative nutritional support has been demonstrated in severely malnourished patients undergoing major surgery. A statistically significant decrease in the incidence of postoperative gastrointestinal symptoms, a reduction in the length of hospital stay and less morbidity occurred on the group that received perioperative nutrition.
authors.affiliation: Unidad de Nutrición, Servicio de Medicina Intensiva, Hospital General Universitario Reina Sofía, and Departamento de Cirugía, Universidad de Murcia, Murcia, Spain. maribigs@yahoo.es
authors.forename: Ma B
authors.initials: MB
authors.lastname: Gómez Sánchez
authors.forename: N V
authors.initials: NV
authors.lastname: García Talavera Espín
authors.forename: T
authors.initials: T
authors.lastname: Monedero Saiz
authors.forename: C
authors.initials: C
authors.lastname: Sánchez Álvarez
authors.forename: A I
authors.initials: AI
authors.lastname: Zomeño Ros
authors.forename: M
authors.initials: M
authors.lastname: Nicolás Hernández
authors.forename: Ma J
authors.initials: MJ
authors.lastname: Gómez Ramos
authors.forename: P
authors.initials: P
authors.lastname: Parra Baños
authors.forename: F M
authors.initials: FM
authors.lastname: González Valverde
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D004032:Diet; D018450:Disease Progression; D004311:Double-Blind Method; D004750:Enteral Nutrition; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000601:surgery* / Q000628:therapy*; D006801:Humans; D007239:Infections / Q000150:complications; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy / Q000379:methods*; D009752:Nutritional Status; D018529:Nutritional Support; D019990:Perioperative Care / Q000379:methods*; D011446:Prospective Studies; D012737:Sex Factors