The influence of short-term pre-operative intravenous nutrition upon anthropometric variables, protein synthesis and immunological indices in patients with gastrointestinal cancer

Zeiderman, M.R.; Gowland, G.; Peel, Benjamine Van; McMahon, Michael

doi:10.1016/0261-5614(91)90041-a

Cited by 6 publications

(6 citation statements)

References 28 publications

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“…These dosages should not be considered as far from adequate for aged patients with advanced-stage neo plastic disease. Furthermore, the calorie and nitrogen are comparable with the dosages given by Zeiderman [16]. Similar to the observation ofYamanaka et al [10], in this study, most of the anastomotic leakages developed in patients undergoing total gastrectomy; regional circula- [19] assessing bursting strength of colonic anastomosis in rats showed convincingly that preoperative chronic and acute (1 week) protein depletion adversely affects colonic healing.…”

Section: Discussionsupporting

confidence: 75%

“…The findings are at variance with those of the study of normal-nourished rats in which a positive effect on healing of colon anastomosis was demonstrated [17], and the patients of Zeiderman [16] after short-term pre operative TPN [16], However, the findings of this study are consistent with the results of the multicenter study of Buzby et al [ 18], which provided strong evidence against clinically important efficacy in mildly or moderately mal nourished patients. It should be mentioned that the surgi cal patients in that study received TPN for 7-15 days before surgery and 3 days afterwards.…”

Section: Discussioncontrasting

confidence: 55%

“…While malnourished gastric cancer pa tients are at higher risk of complications and even death after surgical procedures [10], the prospective control study of the effect of nutritional support such as TPN on the postoperative outcome of aged patients has rarely been evaluated. Zeidermen et al [16], who studied pa tients who were in their 60s, demonstrated an increase in protein synthesis in the liver and muscle, and also some improvement in immunity parameters in patients who were given 3 days of preoperative TPN.…”

Section: Discussionmentioning

confidence: 99%

“…Results of some studies showed that perioperative TPN exhibited beneficial effects in severely malnourished surgical patients [16,18], Müller et al [22] also claimed that restoration of a malnourished cancer patient to nor mal nutritional status could reduce the postoperative complications. The results of the present study revealed that patients in group B were still at high risk of leakage and infections in spite of pre-and postoperative TPN although their body weight and MAMC were maintained.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Total Parenteral Nutrition on the Postoperative Outcome in Aged Patients with Gastric Cancer

Wu¹,

Meng²,

Mok³

et al. 1995

Dig Surg

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This study was performed to evaluate the effect of total parenteral nutrition (TPN) on the postoperative outcome in aged patients (≧ 70 years) with gastric cancer. Patients with normal or mild malnutrition were randomly assigned to two groups: A-1 (n = 20) with postoperative TPN (10 days) and A-2 (n = 20) without TPN, but given intravenous isotonic glucose. Group B (n = 11) having two of the following conditions were selected: > 20% loss of usual body weight, serum albumin < 3.0 g/dl and serum transferrin < 175 mg/dl, cell-mediated immunity multiskin tests < 2 positive. They received preoperative (10 days) and postoperative (2 weeks or longer) TPN. The results showed that anthropometric variables, blood biochemistry and complications were similar in groups A-l and A-2. Group B had significant lower mid-arm muscle circumference and serum protein immediately after surgery and higher anastomotic leakage and infections than groups A-1 and A-2. These findings suggest that TPN had no apparent beneficial effect on the postoperative course in aged patients with normal or mild malnutrition. Those patients (group B) with severe malnutrition were at high risk of anastomotic leakage and infections despite TPN support.

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Section: Discussionsupporting

confidence: 75%

Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of Total Parenteral Nutrition on the Postoperative Outcome in Aged Patients with Gastric Cancer

Wu¹,

Meng²,

Mok³

et al. 1995

Dig Surg

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“…Weight loss was the most commonly used criteria for cancer cachexia assessment; however, application of this measure alone poses major concerns in misclassification and unintended exclusion of cachectic patients. Many studies were published prior to the widespread use of CT images to quantify muscle, as well as prior to the publication of the international cachexia consensus, which defines muscle mass as a diagnostic criterion for cachexia . The premise of using weight loss when muscle is being evaluated is erroneous.…”

Section: Discussionmentioning

confidence: 99%

Clinical and biological characterization of skeletal muscle tissue biopsies of surgical cancer patients

Anoveros‐Barrera

Bhullar

Stretch

et al. 2019

J cachexia sarcopenia muscle

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Background Researchers increasingly use intraoperative muscle biopsy to investigate mechanisms of skeletal muscle atrophy in patients with cancer. Muscles have been assessed for morphological, cellular, and biochemical features. The aim of this study was to conduct a state-of-the-science review of this literature and, secondly, to evaluate clinical and biological variation in biopsies of rectus abdominis (RA) muscle from a cohort of patients with malignancies. Methods Literature was searched for reports on muscle biopsies from patients with a cancer diagnosis. Quality of reports and risk of bias were assessed. Data abstracted included patient characteristics and diagnoses, sample size, tissue collection and biobanking procedures, and results. A cohort of cancer patients (n = 190, 88% gastrointestinal malignancies), who underwent open abdominal surgery as part of their clinical care, consented to RA biopsy from the site of incision. Computed tomography (CT) scans were used to quantify total abdominal muscle and RA cross-sectional areas and radiodensity. Biopsies were assessed for muscle fibre area (μm 2 ), fibre types, myosin heavy chain isoforms, and expression of genes selected for their involvement in catabolic pathways of muscle. Results Muscle biopsy occurred in 59 studies (total N = 1585 participants). RA was biopsied intraoperatively in 40 studies (67%), followed by quadriceps (26%; percutaneous biopsy) and other muscles (7%). Cancer site and stage, % of male participants, and age were highly variable between studies. Details regarding patient medical history and biopsy procedures were frequently absent. Lack of description of the population(s) sampled and low sample size contributed to low quality and risk of bias. Weight-losing cases were compared with weight stable cancer or healthy controls without considering a measure of muscle mass in 21 out of 44 studies. In the cohort of patients providing biopsy for this study, 78% of patients had preoperative CT scans and a high proportion (64%) met published criteria for sarcopenia. Fibre type distribution in RA was type I (46% ± 13), hybrid type I/IIA (1% ± 1), type IIA (36% ± 10), hybrid type IIA/D (15% ± 14), and type IID (2% ± 5). Sexual dimorphism was prominent in RA CT cross-sectional area, mean fibre cross-sectional area, and in expression of genes associated with muscle growth, apoptosis, and inflammation (P < 0.05). Medical history revealed multiple co-morbid conditions and medications. Conclusions Continued collaboration between researchers and cancer surgeons enables a more complete understanding of mechanisms of cancer-associated muscle atrophy. Standardization of biobanking practices, tissue manipulation, patient characterization, and classification will enhance the consistency, reliability, and comparability of future studies.

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Nutrition support in hospitalised adults at nutritional risk

Feinberg

Nielsen

Korang

et al. 2017

Cochrane Database of Systematic Reviews

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There is low-quality evidence for the effects of nutrition support on mortality and serious adverse events. Based on the results of our review, it does not appear to lead to a risk ratio reduction of approximately 10% or more in either all-cause mortality or serious adverse events at short-term and long-term follow-up.There is very low-quality evidence for an increase in weight with nutrition support at the end of treatment in hospitalised adults determined to be at nutritional risk. The effects of nutrition support on all remaining outcomes are unclear.Despite the clinically heterogenous population and the high risk of bias of all included trials, our analyses showed limited signs of statistical heterogeneity. Further trials may be warranted, assessing enteral nutrition (tube-feeding) for different patient groups. Future trials ought to be conducted with low risks of systematic errors and low risks of random errors, and they also ought to assess health-related quality of life.

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The influence of short-term pre-operative intravenous nutrition upon anthropometric variables, protein synthesis and immunological indices in patients with gastrointestinal cancer

Cited by 6 publications

References 28 publications

Effect of Total Parenteral Nutrition on the Postoperative Outcome in Aged Patients with Gastric Cancer

Effect of Total Parenteral Nutrition on the Postoperative Outcome in Aged Patients with Gastric Cancer

Clinical and biological characterization of skeletal muscle tissue biopsies of surgical cancer patients

Nutrition support in hospitalised adults at nutritional risk

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