title: [Influence of preoperative nutritional support on surgical outcomes of chronic radiation enteritis patients complicated with intestinal obstruction].
abstract: OBJECTIVE
  To investigate the effect of preoperative nutritional support in the management of patients with chronic radiation enteritis (CRE) with intestinal obstruction undergoing resectional surgery.
  
  
  METHODS
  Clinical data of 158 CRE patients undergoing diseased bowel resection from 2001 to 2011 were analyzed retrospectively. A total of 130 patients received preoperative nutritional support, including 28 patients with enteral nutrition support, 60 patients with total parenteral nutrition support, and 42 patients with combined nutritional support. The nutritional parameters, procedures, operation-related complications, and postoperative hospital stay were recorded.
  
  
  RESULTS
  After aggressive nutritional support in 130 patients, patients nutritional index, such as serum prealbumin, transferrin, serum albumin improved significantly preoperatively, while the change of body mass index and hemoglobin was not significant. Compared to those without preoperative nutritional support, those who received preoperative nutritional support had lower stoma rate (31.5% vs. 53.6%, P=0.027), less postoperative infection rate (13.8% vs. 32.1%, P=0.019), shorter postoperative hospital stay [(14.1±7.3) d vs. (18.8±15.8) d, P=0.013). Enteral nutrition group had less postoperative infection rate (7.1% vs. 21.7%, P=0.017), lower stoma rate (28.6% vs. 48.3%, P=0.02), and shorter postoperative hospital stay [(15.5±9.6) d vs. (21.7±19.0) d, P=0.025) as compared to total parenteral nutrition group.
  
  
  CONCLUSIONS
  Preoperative nutritional support can decrease the stoma rate, postoperative infection rate, and shorten hospital stay in CRE patients complicated with intestinal obstruction. If tolerated, enteral nutrition support should be chosen.
authors.affiliation: Nanjing University School of Medicine, Nanjing, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhang
authors.forename: Jian-feng
authors.initials: JF
authors.lastname: Gong
authors.forename: Ling
authors.initials: L
authors.lastname: Ni
authors.forename: Qi-yi
authors.initials: QY
authors.lastname: Chen
authors.forename: Zhen
authors.initials: Z
authors.lastname: Guo
authors.forename: Wei-ming
authors.initials: WM
authors.lastname: Zhu
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Jie-shou
authors.initials: JS
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004751:Enteritis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018529:Nutritional Support / Q000379:methods*; D011300:Preoperative Care; D011832:Radiation Injuries / Q000150:complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult