Nutrition update in gastric cancer surgery.
Takeshi KubotaKatsutoshi ShodaHirotaka KonishiKazuma OkamotoEigo OtsujiPublished in: Annals of gastroenterological surgery (2020)
Patients with gastric cancer are often malnourished during tumor progression. Malnutrition is a risk factor for postoperative complications and a poor prognosis. Early evaluation and management of nutrition can improve these outcomes. Various combined indices in which albumin is the primary component are used to evaluate the nutritional status, including the Prognostic Nutritional Index, Glasgow Prognostic Score, and Controlling Nutritional Status score. Both the American Society for Parenteral and Enteral Nutrition and the European Society for Clinical Nutrition and Metabolism guidelines recommend immediate and early oral/enteral nutrition. However, few reports have described the additional effects of preoperative immunonutrition on clinical outcomes of gastric cancer surgery. Gastrectomy types and reconstruction methods that consider the postoperative nutritional status have been used when oncologically acceptable. Total gastrectomy has recently tended to be avoided because of its negative impact on nutritional status. New findings obtained from the emergence of continuous glucose measurement, such as glucose fluctuation and nocturnal hypoglycemia, may affect nutritional management after gastrectomy. Some prospective clinical studies on perioperative nutritional intervention have set postoperative body weight loss as a primary endpoint. It seems important to continue oral nutritional supplement, even in small doses, to reduce body weight loss after gastrectomy. Evidence generated by prospective, well-developed randomized controlled studies must be disseminated so that nutritional therapy is widely recognized as an important multimodal therapy in patients undergoing gastric cancer surgery.
Keyphrases
- patients undergoing
- poor prognosis
- weight loss
- minimally invasive
- physical activity
- coronary artery bypass
- long non coding rna
- bariatric surgery
- randomized controlled trial
- blood glucose
- blood pressure
- open label
- cardiac surgery
- obstructive sleep apnea
- gastric bypass
- roux en y gastric bypass
- percutaneous coronary intervention
- body mass index
- clinical trial
- emergency department
- double blind
- phase iii
- atrial fibrillation
- stem cells
- pain management
- clinical practice
- adipose tissue
- depressive symptoms
- skeletal muscle
- cell therapy
- obese patients
- weight gain
- phase ii
- coronary artery disease