title: Parenteral nutrition and preOp preparation in prevention of post-operative insulin resistance in gastrointestinal carcinoma.
abstract: OBJECTIVE
  The aim was to compare preventive effect of total parenteral nutrition (TPN) and oral nutrition (preOp) on the perioperative insulin resistance prevention in surgical gastrointestinal cancer patients.
  
  
  METHODS
  The study was conducted in a group of 75 elective gastric and large intestine cancer patients. Patients were randomly divided into 3 study groups, 25 patients each: group I (NIL) - no preparations influencing tissue sensitivity to insulin, group II (TPN) - total parenteral nutrition in its preoperative stage and group III (TPN + preOp) parenteral nutrition and preOp in the preoperative phase.
  
  
  RESULTS
  Immediately after the surgery, no statistically significant differences in insulin resistance level between groups were observed. During the first 6 postoperative hours, a statistically significant decrease of insulin resistance level in the TPN+ preOp group in comparison to others, was observed. During the first 24 postoperative hours, the NIL group was the only one to keep the insulin resistance level the same as in the preoperative phase.
  
  
  CONCLUSIONS
  Application of TPN in the preoperative phase leads to shortening of perioperative insulin resistance time. Combining TPN with oral application of carbohydrate before surgical procedure is an effective and the best method in postoperative insulin resistance syndrome prevention.
authors.affiliation: 2nd Department of General and Gastroenterological Surgery, Medical University of Bialystok, Bialystok, Poland. nikt00@gazeta.pl
authors.forename: K
authors.initials: K
authors.lastname: Zareba
authors.forename: M
authors.initials: M
authors.lastname: Czygier
authors.forename: Z
authors.initials: Z
authors.lastname: Kamocki
authors.forename: D
authors.initials: D
authors.lastname: Cepowicz
authors.forename: M
authors.initials: M
authors.lastname: Szmitkowski
authors.forename: B
authors.initials: B
authors.lastname: Kedra
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002241:Carbohydrates / Q000008:administration & dosage; D002277:Carcinoma / Q000150:complications* / Q000601:surgery*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D057234:Preoperative Period; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D002241:Carbohydrates; D007328:Insulin