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World J Gastroenterol. Apr 21, 2006; 12(15): 2441-2444
Published online Apr 21, 2006. doi: 10.3748/wjg.v12.i15.2441
Perioperative artificial nutrition in malnourished gastroin-testinal cancer patients
Guo-Hao Wu, Zhong-Hua Liu, Zhao-Han Wu, Zhao-Guang Wu
Guo-Hao Wu, Zhao-Han Wu, Zhao-Guang Wu, Zhong-hua Liu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Correspondence to: Guo-Hao Wu, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China. wugh@zshospital.net
Telephone: +86-21-64041990-2312 Fax: +86-21-64038472
Received: August 30, 2004
Revised: July 2, 2005
Accepted: November 14, 2005
Published online: April 21, 2006

AIM: 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).

CONCLUSION: Perioperative nutrition support is beneficial for moderately or severely malnourished gastrointestinal cancer patients and can reduce surgical complications and mortality.

Keywords: Malnutrition, Perioperative nutrition, Parenteral nutrition, Enteral nutrition, Mortality, Complications