The effects of pre-operative nutrition on colon anastomosis healing in malnourished rats

Gündoğdu, Rıza Haldun; Yaşar, Uğur; Ersoy, Pamir Eren; Ergül, Emre; Işıkoğlu, Semra; Erhan, Atilla

doi:10.5152/ucd.2015.3077

Cited by 9 publications

(8 citation statements)

References 17 publications

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“…In another recent study involving animal experiments, Gündogdu et al (18) reported that preoperative oral nutritional intervention improved anastomotic wound healing in calorically-restricted rats. In our current study, we found that the postoperative administration of PPN solutions containing 3% amino acids promoted wound healing in protein-malnourished rats.…”

Section: A B C Dmentioning

confidence: 99%

Effects of Parenteral Amino Acid Administration on the Postoperative Nutritional Status and Wound Healing of Protein-Malnourished Rats

Wada

Sonoda

Makino

et al. 2018

J Nutr Sci Vitaminol

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In Japan, parenteral nutrition (PN) solutions are frequently administered to patients in the postoperative short-term period. In these cases, amino acid-containing peripheral parenteral nutrition (PPN) solutions, amino acid-free maintenance solutions or combinations of the two are used. However, consensus regarding the most beneficial solution for these patients is lacking. Here, we examined the nutritional status and wound healing outcomes in protein-malnourished rats receiving postoperative administrations of PPN solution, maintenance solution or combinations of the two solutions. Protein malnutrition was induced in Sprague-Dawley rats by feeding an AIN-93G-based low-protein diet (5% casein) for 2 wk. After laparotomy, dorsal skin incision, and placement of a jugular vein catheter, the rats were divided into 3 groups. Each group was administered 113 kcal/kg/d, with group A receiving maintenance solutions without amino acid, group B receiving PPN with 1.5% amino acid, and group C receiving PPN with 3% amino acid. After 5 d post-operative administration, we measured the tensile strength of the wound area, skeletal muscle weights, and nutritional parameters. Significantly higher plasma nutritional parameters and gastrocnemius and extensor digitorum longus (EDL) muscle weights were observed in groups B and C than in group A. Group C exhibited significantly elevated tensile strength of the wound area along with up-regulation of type I collagen mRNA expression compared to group A. These findings demonstrate the nutritional status and wound healing benefits of short-term postoperative administration of PPN solutions containing amino acids in protein-malnourished rats.

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Section: A B C Dmentioning

confidence: 99%

Effects of Parenteral Amino Acid Administration on the Postoperative Nutritional Status and Wound Healing of Protein-Malnourished Rats

Wada

Sonoda

Makino

et al. 2018

J Nutr Sci Vitaminol

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“…In emergency settings, one-stage surgery is the best choice, when possible, in selected patients; two stage surgery is indicated in case of peritonitis, in patients hemodinamically unstable and in case of malnourished patients (hypoalbumineamia), due to the high risk of anastomotic leakage [44] ; decompressive colostomy or ileostomy is indicated as bridge to elective surgery in operable patients, or as palliative procedure, in advanced neoplastic disease and peritoneal carcinomatosis. Cennamo and Al recently carried out a meta-analysis of randomized trials comparing endoscopic stenting and surgical decompression for colorectal cancer obstruction and concluded that in patients with acute colorectal obstruction, SEMS placement improves several outcomes, such as primary anastomosis, stoma formation, and permanent stoma, while it failed to show an improvement in mortality and morbidity risk [45] .…”

Section: Resultsmentioning

confidence: 99%

Emergency Surgery for Colorectal Cancer in Patients Aged Over 90 Years: Review of the Recent Literature

Belinda

Catena

2016

Journal of Tumor

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derly people; approximately 60% of patients are aged >70 years at time of diagnosis and 43% of cases are aged >75 years in the western countries [1][2][3] . These proportions will likely continue to increase in the near future, because of the increasing percentage of people living past ninety years, a phenomenon associated with the aging world population.In Italy, according to the Italian National Institute of Statistics (ISTAT) data, the population aged 85 and older will increase from 2.8% in 2011 to 7.8% in 2050, reaching an average life expectancy of 85.3 years for males and 90.5 years for females.This highly significant demographic change in modern society has an important impact on health care, especially in cancer care, as cancer in people aged over 90, poses an ethical dilemma for surgeons and oncologists: non operative management or medical and/or surgical treatment? To treat is an over treatment?In clinical practice, the management of this group of patients is frequently suboptimal, consequently an increasing number of nonagenarian CRC patients are admitted in emergency departments, requiring surgical treatment.Generally, emergency abdominal procedures are associated with increased morbidity and mortality rates, particularly for frail elderly patients. The emergency surgeon often has the crucial role of selecting which patients to submit to surgery, balancing the benefits and the high surgical risk associated with comorbidities.Another important issue to consider is the high costs of the postoperative care for this group of patients which frequently demand rehabilitation and longer recovery, even after minor surgery.We decided to review the recent literature to discuss current strategies in the management of oncogeriatric patients aged over ninety in emergency. MATERIALS AND METHODSWe performed a search by Cochrane Library, MEDLINE, and EMBASE for potentially relevant scientific articles on emergency surgery for colorectal cancer in nonagenarian patients. We considered in our review all the scientific papers published in the last ten years up to June 2015. We included in this study randomized controlled ABSTRACTThe aging of the world population is leading to an increase in the number of patients aged over ninety needing for a surgical treatment in emergency setting. Colorectal cancer in people over 90 years of age represents an ethical dilemma for surgeons and oncologists, above all when the neoplastic disease is advanced and complicated by obstruction and/or perforation. The emergency surgeon often has the crucial role of selecting which patients to submit to surgery, balancing the benefits and the high surgical risk associated with frailty, polipharmacy and comorbidities.We decided to review the recent literature to discuss the latest strate-gies in the management of colorectal cancer in emergency situations, for patients aged over ninety.

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“…The failure of hepaticojejunostomy anastomosis in our patient might be due to her malnourished condition. There are several factors that can affect the anastomosis healing process, consisting of the primary disease, presence of infection, and patient's nutritional status [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Acquired choledochal cyst following intraabdominal tumor surgical excision: A case report

Gunadi

Ramadhita

Fauzi

et al. 2020

Annals of Medicine and Surgery

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Introduction Choledochal cyst (CC) is a morphological malformation characterized by dilatations of the biliary tree that might present later with clinical symptoms, including jaundice, abdominal pain or pancreatitis. Presentation of case Here, we reported a 10-month-old female infant with CC presenting with jaundice and a right upper quadrant mass and who was malnourished following a surgical excision of retroperitoneal teratoma one month ago. Laboratory findings were total bilirubin of 14.17 mg/dL, direct bilirubin of 12.24 mg/dL, gamma glutamyl transferase of 1157 U/L, and alkaline phosphatase 187 U/L. Abdominal computed tomography scan showed a CC that caused dilatation of the proximal common bile duct (CBD), common hepatic duct, and intrahepatic bile duct. We decided to perform an explorative laparotomy and found a CC with diameter of 5 cm. Then, we conducted a Roux-en-Y hepaticojejunostomy. Due to hepaticojejunostomy anastomosis leakage, relaparotomies were done. The patient was uneventfully discharged 17 days after the third surgery. Discussion Our findings are unique because the patient had a normal biliary tree previously and underwent intraabdominal tumor surgery. Notably, besides being an acquired CC, our case might be due to inadvertent bile duct ligation during the first operation or bile duct obstruction as a complication of the first operation. Conclusions CC should be considered as a potential complication of intraabdominal tumor excision, especially if its location is near the CBD. Roux-en-Y hepaticojejunostomy is still the best choice for CC management.

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The effects of pre-operative nutrition on colon anastomosis healing in malnourished rats

Cited by 9 publications

References 17 publications

Effects of Parenteral Amino Acid Administration on the Postoperative Nutritional Status and Wound Healing of Protein-Malnourished Rats

Effects of Parenteral Amino Acid Administration on the Postoperative Nutritional Status and Wound Healing of Protein-Malnourished Rats

Emergency Surgery for Colorectal Cancer in Patients Aged Over 90 Years: Review of the Recent Literature

Acquired choledochal cyst following intraabdominal tumor surgical excision: A case report

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