Perioperative artificial nutrition in malnourished gastrointestinal cancer patients

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 cl, P = 0.014) than those of the studied patients (23 vs 12 cl, P = 0.000). CONCLUSION: Perioperative nutrition support is beneficial for moderately or severely malnourished gastrointestinal cancer patients and can reduce surgical complications and mortality. (c) 2006 The WJG Press. All rights reserved.