ZHANG xing-xia
postgraduate student of West China School of Nursing, Sichuan University
Title: Research review of preoperative nutritional support in elective surgery patients with gastrointestinal cancer
Biography
Biography: ZHANG xing-xia
Abstract
The incidence of malnutrition in patients with gastrointestinal (GI) cancer is high, preoperative nutritional support can effectively improve the clinical outcomes. However, due to various factors, preoperative nutritional support has not been widely used in clinic. So we systematically searched the evidences of preoperative nutritional support in GI cancer and reviewed the evaluation of malnutrition in patients with GI tumors, indications, approaches, duration, types and dosage of nutritional supplements for preoperative nutritional support, and there are some doubts were identified.As for nutrition evaluation, there are many tools used in the clinical, however, no one can systematically evaluate the patient′s nutrition status. A new tool which combined laboratory with anthropometric and subjective evaluations is necessary to be created and the body composition must be emphasized. And there are just a few surgeons can implemented nutrition screen routinely. As for well-nourished patients, there was just a few paper investigate it and the effects of nutritional support were inconsistent, so, weather the well-nourished patients would be given preoperative nutritional support need further study. As for the ways of nutritional support, the consensus has been reached that the enteral nutrition (EN) is superior to praenteral nutrition (PN) for surgery patient, however, the effects of EN combined with PN for gastrointestinal cancer patient in unclear. Another key confusion is how to chose the volume and type of nutritional formula, there are limited numbers of prospective, randomized trials supporting the concept that formula choice yields a significant benefit and many studies did not reported the information about the volume and type of nutritional formula. All of these questions render the popularization of preoperative nutritional support in GI cancer patient. So, a guideline for GI cancer patient to direct the use of preoperative nutritional support is needed.