The relationship between the GLIM-defined malnutrition, body composition and functional parameters, and clinical outcomes in elderly patients undergoing radical gastrectomy for gastric cancer

Author(s):  
Dong-Dong Huang ◽  
Ding-Ye Yu ◽  
Hao-Nan Song ◽  
Wen-Bin Wang ◽  
Xin Luo ◽  
...  
Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1781
Author(s):  
Emanuele Rinninella ◽  
Alberto Biondi ◽  
Marco Cintoni ◽  
Pauline Raoul ◽  
Francesca Scialanga ◽  
...  

Background: A poor body composition, often found in elderly patients, negatively impacts perioperative outcomes. We evaluated the effect of a perioperative nutritional protocol (NutriCatt) on body composition and clinical outcomes in a cohort of elderly patients undergoing colorectal surgery in a high-volume center adopting the ERAS program. Methods: 302 out of 332 elderly (>75 years) patients from 2015 to 2020 were identified. Patients were divided according to their adherence, into “NutriCatt + ERAS” (n = 166) or “standard ERAS” patients (n = 136). Anthropometric and bioelectrical impedance analysis data were evaluated for NutriCatt + ERAS patients. Complications, length of hospital stay (LOS), and other postoperative outcomes were compared between both groups. Results: In NutriCatt + ERAS patients, significant improvements of phase angle (pre-admission vs. admission 4.61 ± 0.79 vs. 4.84 ± 0.85; p = 0.001; pre-admission vs. discharge 4.61 ± 0.79 vs. 5.85 ± 0.73; p = 0.0002) and body cell mass (pre-admission vs. admission 22.4 ± 5.6 vs. 23.2 ± 5.7; p = 0.03; pre-admission vs. discharge 22.4 ± 5.6 vs. 23.1 ± 5.8; p = 0.02) were shown. NutriCatt + ERAS patients reported reduced LOS (p = 0.03) and severe complications (p = 0.03) compared to standard ERAS patients. A regression analysis confirmed the protective effect of the NutriCatt protocol on severe complications (OR 0.10, 95% CI 0.01–0.56; p = 0.009). Conclusions: The NutriCatt protocol improves clinical outcomes in elderly patients and should be recommended in ERAS colorectal surgery.


2016 ◽  
Vol 42 (2) ◽  
pp. 303-311 ◽  
Author(s):  
C.-J. Zhou ◽  
F.-F. Chen ◽  
C.-L. Zhuang ◽  
W.-Y. Pang ◽  
F.-Y. Zhang ◽  
...  

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15528-e15528
Author(s):  
Wei Wang ◽  
Wenjun Xiong ◽  
Jin Wan

e15528 Background: Iatrogenic splenic injury may lead to conversion or nontherapeutic splenectomy in laparoscopic gastrectomy. A critical point at splenic injury occurs is improper traction of spleen-omentum ligament which was called crimimal ligament (CL). We aimed to explore the efficacy of cirminal ligament priority separating (CLPS) to reduce iatrogenic splenic injury in laparoscopic radical gastrectomy. Methods: Complete videos of 540 laparoscopic radical gastrectomy in Guangdong Provincial Hospital of Chinese Medicine were reviewed. The relationship between CLPS and iatrogenic splenic injury was determined. CL was defined as the ligament between omentum and spleen. CLPS was defined as that CL was firstly separated when mobilization was in left upper quadrant. Results: CL was present in 81.5% (440/540) and were included for analysis. There was variation in the distribution pattern of CL and it mostly appeared in the lower pole of spleen (414/440). CLPS was performed in 24.5% (108/440) and 75.5% (332/440) were not (un-CLPS). In systematic review, the incidence of iatrogenic splenic injury was 10.9% (48/440). Among these patients, 79.1% (38/48) were due to improper traction of CL and they were all in un-CLPS group. Instrument injury was occurred in 2.2% (10/440) and 3 were in CLPS group and 7 were in un-CLPS group. Most iatrogenic splenic injury were successfully handled with electrocoagulation, adhesive and compression technique, except 2 patients underwent conversion to open splenectomy for serious splenic injury in un-CLPS group. Conclusions: In laparoscopic surgery for gastric cancer, iatrogenic splenic injury mostly resulted from improper traction of CL and CLPS could reduce the incidence of iatrogenic splenic injury.


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