The effects of nutritional support on selected laboratory parameters in patients with colorectal cancer undergoing surgical resection of the colon.
DOI:
https://doi.org/10.5219/1355Keywords:
nutridrink, enteral nutrition, malnutrition, colon, hypoalbuminemiaAbstract
The benefit of the nutritional support provided to patients with colorectal cancer who have undergone the planned resection of the colon in relation to the laboratory markers of nutrition was examined. And it is currently being discussed, that pre-operative optimization of nutritional status reduces the incidence of post-operative complications in cancer patients and regulates selected laboratory parameters. This was a retrospective study where the treatment group (n = 52) received the enteral nutritional support 21 days prior to the scheduled surgery and the other group was formed of patients without preoperative enteral nutrition (n = 52). Laboratory parameters (CRP, leukocytes, albumin, total proteins) were monitored for at least one month before the planned surgery and just before the operation, and the effect of supplemental enteral nutrition on selected laboratory parameters between these two groups was compared. In a group of patients with enteral nutrition, serum albumin levels increased significantly, while CRP was significantly reduced during preoperative enteral nutrition (albumin S-ALB from 35.42 to 37.48, p = 0.0008, C reactive protein from 26.5 to 14.092, p = 0.0007). Nutritional support 21 days prior to surgery in oncological patients resulted in an improvement in laboratory parameters compared to the group of patients without nutritional enteric support. Malnutrition in patients who are candidates for major surgical intervention is a risk factor for postoperative morbidity and mortality. However, further studies are required to verify the effectiveness of this early nutritional intervention on medium and long-term clinical parameters in different types of cancer.
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Altintas, N. D., Aydin, K., Türkoğlu, M. A., Abbasoğlu, O., Topelli, A. 2011. Effect of Enteral Versus Parenteral Nutrition on Outcome of Medical Patients Requiring Mechanical Ventilation. Nutrition in Clinical Practice, vol. 26, no. 3, p. 322-329. https://doi.org/10.1177/0884533611405790
Arends, J., Bachmann, P., Baracos, V., Barthelemy, N., Bertz, H., Bozzetti, F., Fearon, K., Hütterer, E., Isenring, E., Kaasa, S., Krznaric, Z., Laird, B., Larsson, M., Laviano, A., Mühlebach, S., Muscaritoli, M., Oldervoll, L., Ravasco, P., Solheim, T., Strasser, F., de van der Schueren, M., Preiser, J. C. 2017. ESPEN guidelines on nutrition in cancer patients. Clinical Nutrition, vol. 36, no. 1, p. 11-48. https://doi.org/10.1016/j.clnu.2016.07.015
Atkinson, S., Sieffert, E., Bihari, D. 1998. A prospective, randomized, double-blind, controlled clinical trial of enteral immunonutrition in the critically ill. Critical Care Medicine, vol. 26, no. 7, p. 1164-1172. https://doi.org/10.1097/00003246-199807000-00013
Bower, R. H., Cerra, F. B., Bershadsky, B., Licari, J. J., Hoyt, D. B., Jensen, G. L., Van Buren, C. T., Rothkopf, M. M., Daly, J. M., Adelsberg, B. R. 1995. Early enteral administration of a formula (Impact Registered Trademark) supplemented with arginine, nucleotides, and fish oil in intensive care unit patients: Results of a multicenter, prospective, randomized, clinical trial. Critical Care Medicine, vol. 23, no. 3, p. 436-449. https://doi.org/10.1097/00003246-199503000-00006
Braga, M., Gianotti, L., Nespoli, L., Radaelli, G., Di Carlo, V. 2002. Nutritional Approach in Malnourished Surgical Patients: A Prospective Randomized Study. Archives of Surgery, vol. 137, no. 2, p. 174-180. Available at: https://jamanetwork.com/journals/jamasurgery/fullarticle/212080
Braga, M., Gianotti, L., Radaelli, G., Vignali, A., Mari, G., Gentilini, O., Di Carlo, V. 1999. Perioperative Immunonutrition in Patients Undergoing Cancer Surgery: Results of a Randomized Double-blind Phase 3 Trial. Archives of Surgery, vol. 134, no. 4, p. 428-433. Available at: https://jamanetwork.com/journals/jamasurgery/fullarticle/390270
Crockett, S. D., Mott, L. A., Barry, E. L., Figueiredo, J. C., Burke, C. A., Baxter, G. J., Sandler, R. S., Baron, J. A. 2014. C-reactive Protein and Risk of Colorectal Adenomas or Serrated Polyps: A Prospective Study. Cancer Preventation Research, vol. 7, no. 11, p. 1122-1127. https://doi.org/10.1158/1940-6207.CAPR-14-0167
Feng, J. F., Zhao, Q., Chen, Q. X. 2014. Prognostic significance of Glasgow prognostic score in patients undergoing esophagectomy for esophageal squamous cell carcinoma. The Saudi Journal of Gastroenterology, vol. 20, no. 1, p. 48-53. Available at: http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2014;volume=20;issue=1;spage=48;epage=53;aulast=Feng
Gallois, C., Artru, P., Lièvre, A., Auclin, E., Lecomte, T., Locher, C., Marthey, L., Zaimi, Y., Faroux, R., Pernot, S., Barret, M., Taieb, J. 2019. Evaluation of two nutritional scores' association with systemic treatment toxicity and survival in metastatic colorectal cancer: an AGEO prospective multicentre study. European Journal of Cancer, vol. 119, p. 35-43. https://doi.org/10.1016/j.ejca.2019.07.011
Gianotti, L., Braga, M., Gentilini, O., Balzano, G., Zerbi, A., DiCarlo, V. 2000. Artificial Nutrition After Pancreaticoduodenectomy. Pancreas, vol. 21, no. 4, p. 344-351. https://doi.org/10.1097/00006676-200011000-00004
Gianotti, L., Braga, M., Nespoli, L., Radaelli, G., Beneduce, A., Di Carlo, V. 2002. A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer. Gastroenterology, vol. 122, no. 7, p. 1763-1770. https://doi.org/10.1053/gast.2002.33587
Gianotti, L., Braga, M., Vignali, A., Balzano, G., Zerbi, A., Bisagni, P., Di Carlo, V. 1997. Effect of Route of Delivery and Formulation of Postoperative Nutritional Support in Patients Undergoing Major Operations for Malignant Neoplasms. Archives of Surgery, vol. 132, no. 11, p. 1222-1230. Available at: https://jamanetwork.com/journals/jamasurgery/article-abstract/596990
Giger-Pabst, U., Lange, J., Maurer, C., Bucher, C., Schreiber, V., Schlumpf, R., Kocher, T., Schweizer, W., Krähenbühl, S., Krähenbühl, L. 2013. Short-term preoperative supplementation of an immunoenriched diet does not improve clinical outcome in well-nourished patients undergoing abdominal cancer surgery. Nutrition, vol. 29, no. 5, p. 724-729. https://doi.org/10.1016/j.nut.2012.10.007
Heslin, M. J., Latkany, L., Leung, D., Brooks, A. D., Hochwald, S. N., Pisters, P. W., Shike, M., Brennan, M. 1997. A Prospective, Randomized Trial of Early Enteral Feeding After Resection of Upper Gastrointestinal Malignancy. Annals of Surgery, vol. 226, no. 4, p. 567-580. Available at: https://journals.lww.com/annalsofsurgery/Abstract/1997/10000/A_Prospective,_Randomized_Trial_of_Early_Enteral.16.aspx
Heyland, D. K., Drover, J. W., MacDonald, S., Novak, F., Lam, M. 2001. Effect of postpyloric feeding on gastroesophageal regurgitation and pulmonary microaspiration: Results of a randomized controlled trial. Critical Care Medicine, vol. 29, no. 8, p. 1495-1501. https://doi.org/10.1097/00003246-200108000-00001
Heyland, D., Muscedere, J., Wischmeyer, P. E., Cook, D., Jones, G., Albert, M., Elke, G., Berger, M. M., Day, A. G. 2013. A Randomized Trial of Glutamine and Antioxidants in Critically Ill Patients. The New England Journal of Medicine, vol. 368, p. 1489-1497. https://doi.org/10.1056/NEJMoa1212722
Chow, R., Bruera, E., Arends, J., Walsh, D., Strasser, F., Isenring, E., Del Fabbro, E. G., Molassiotis, A., Krishnan, M., Chiu, L., Chiu, N., Chan, S., Tang, T. Y., Lam, H., Lock, M., DeAngelis, C. 2020. Enteral and parenteral nutrition in cancer patients a comparison of complication rates: an updated systematic review and (cumulative) meta-analysis. Supportive Care in Cancer, vol. 28, p. 979-1010. https://doi.org/10.1007/s00520-019-05145-w
Klek, S., Kulig, J., Sierzega, M., Szybinski, P., Szczepanek, K., Kubisz, A., Kowalczyk, T., Gach, T., Pach, R., Szczepanik, A. 2008. The Impact of Immunostimulating Nutrition on Infectious Complications After Upper Gastrointestinal Surgery: A Prospective, Randomized, Clinical Trial. Annals of Surgery, vol 248, no. 2, p. 212-220. https://doi.org/10.1097/SLA.0b013e318180a3c1
Klek, S., Sierzega, M., Szybinski, P., Szczepanek, K., Scislo, L., Walewska, E., Kulig, J. 2011. Perioperative nutrition in malnourished surgical cancer patients – A prospective, randomized, controlled clinical trial. Clinical Nutrition, vol. 30, no. 6, p. 708-713. https://doi.org/10.1016/j.clnu.2011.07.007
Nesbakken, A., Nygaard, K., Lunde, O. C., Blücher, J., Gjertsen, Ø., Dullerud, R. 2005. Anastomotic leak following mesorectal excision for rectal cancer: true incidence and diagnostic challenges. Colorectal Disease, vol. 7, no. 6, p. 576-581. https://doi.org/10.1111/j.1463-1318.2005.00870.x
Nutridrink-compact. 2020. Nutridrink Compact neutral. Available at: https://www.drmax.cz/nutridrink-compact-neutral-4x125ml
Oberhofer, D., Juras, J., Pavičić, A. M., Rančić Žurić, I., Rumenjak, V. 2012. Comparison of C-reactive protein and procalcitonin as predictors of postoperative infectious complications after elective colorectal surgery. Croatian Medical Journal, vol. 53, no. 6, p. 612-619. https://doi.org/10.3325/cmj.2012.53.612
Platt, J. J., Ramanathan, M. L., Crosbie, R. A., Anderson, J. H., McKee, R. F., Horgan, P. G., McMillan, D. C. 2012. C-reactive Protein as a Predictor of Postoperative Infective Complications after Curative Resection in Patients with Colorectal Cancer. Annals of Surgical Oncology, vol. 19, p. 4168-4177. https://doi.org/10.1245/s10434-012-2498-9
Sonoda, A., Ohnishi, S., Nakao, S., Iwashita, Y., Hashimoto, N., Ishida, K., Kondo, Y., Ishitsuka, Y., Irie, T. 2015. Factors affecting serum albumin in the perioperative period of colorectal surgery: a retrospective study. BMC Research Notes, vol. 8, 8 p. https://doi.org/10.1186/s13104-015-1632-8
Tokunaga, R., Sakamoto, Y., Nakagawa, S., Izumi, D., Kosumi, K., Taki, K., Higashi, T., Miyata, T., Miyamoto, Y., Yoshida, N., Baba, H. 2017. Comparison of systemic inflammatory and nutritional scores in colorectal cancer patients who underwent potentially curative resection. International Journal of Clinical Oncology, vol. 22, p. 740-748. https://doi.org/10.1007/s10147-017-1102-5
Tominaga, T., Nonaka, T., Hisanaga, M., Fukuda, A., Tanoue, Y., Yoshimoto, T., Hidaka, S., Sawai, T., Nagayasu, T. 2019. Prognostic value of the preoperative prognostic nutritional index in oldest-old patients with colorectal cancer. Surgery Today, vol. 50, p. 449-459. https://doi.org/10.1007/s00595-019-01910-w
Torre, L. A., Bray, F., Siegel, R. L., Ferlay, J., Lortet-Tieulent, J., Jemal, A. 2015. Global cancer statistics, 2012. A Cancer Journal for Clinicians, vol. 65, no. 2, p. 87-108. https://doi.org/10.3322/caac.21262
Truong, A., Hanna, M. H., Moghadamyeghaneh, Z., Stamos, M. J. 2016. Implications of preoperative hypoalbuminemia in colorectal surgery. World Journal of Gastrointestinal Surgery, vol. 8, no. 5, p. 353-362. https://doi.org/10.4240/wjgs.v8.i5.353
Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Hübner, M., Klek, S., Laviano, A., Ljungqvist, O., Lobo, D. N., Martindale, R., Waitzberg, D. L., Bischoff, S. C., Singer, P. 2017. ESPEN guideline: Clinical nutrition in surgery. Clinical Nutrition, vol. 36, no. 3, p.623-650. https://doi.org/10.1016/j.clnu.2017.02.013
Welsch, T., Müller, S. A., Ulrich, A., Kischlat, A., Hinz, U., Kienle, P., Büchler, M. W., Schmidt, J., Schmied, B. M. 2007. C-reactive protein as early predictor for infectious postoperative complications in rectal surgery. International Journal of Colorectal Disease, vol. 22, p. 1499-1507. https://doi.org/10.1007/s00384-007-0354-3
Xu, J., Sun, X., Xin, Q., Cheng, Y., Zhan, Z., Zhang, J., Wu, J. 2018. Effect of immunonutrition on colorectal cancer patients undergoing surgery: a meta-analysis. International Journal of Colorectal Disease, vol. 33, p. 273-283. https://doi.org/10.1007/s00384-017-2958-6
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