ONC: Pre-Operative (2006)
Is there a relationship between the use of preoperative nutrition support to improve nutritional intake (protein, kcals) and the reduction of adverse outcomes associated with surgery for gastric and colorectal cancer patients?
One positive quality RCT found that parenteral or enteral preoperative nutrition support, provided for at least 10 days prior to surgery, and using standard PN and EN formulas, resulted in a small benefit for nutritionally depleted patients receiving surgical treatment for gastric and colorectal cancer when compared to nutritionally depleted patients receiving immediate surgery with no preoperative nutrition support. Benefits of nutrition support included a decreased rate of sepsis (P <0.05) and intra-abdominal abscess formation (P< 0.05). The benefit obtained increased with the degree of nutritional depletion. The researchers found no increased morbidity related to nutrition support. Total stay in PN and EN groups was not significantly longer than the control group, despite longer pre-operative stays in the nutrition support groups. The researchers concluded that only patients with severe nutritional depletion, defined as weight loss > 10% prior to surgery, should receive nutritional support prior to surgery for gastric or colorectal cancer.
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- Evidence Summary: Pre-operative Nutrition Support (Pro/Kcals): Adverse Outcomes for Gastric and Colorectal Cancer
Search Plan and Results: Protein and Symptoms/Complications: Preoperative 2006