PP098-SUN: The Influence of Preoperative Nutritional Status on the Short-Term Outcomes of Colorectal Cancer Surgery Within an Enhanced Recovery Program

Background: Peripheral parenteral nutrition allows repletion of acute nutrient deficiencies and could prevent further nutrition deficits before and after colorectal surgery. A randomized open study was performed to evaluate the effect of perioperative peripheral parenteral nutrition (PPN) support on postoperative morbidity after colorectal cancer surgery within an enhanced recovery program. Methods: Patients were randomized into two groups: peripheral parenteral nutrition (PPN) (with Peri-Olimel N4-E) versus conventional fluid therapy (FT). Ninety-day postoperative complications, laboratory parameters, length of hospital stay, and compliance with the ERAS protocol were assessed. Results: A total of 158 patients were analysed. The overall 90-day complication rate was 38.6% (61 patients), and 24 patients had major complications (Clavien–Dindo III–V) (15.2%). In the multivariate analysis, the intervention (PPN vs. FC) showed a protective effect against postoperative complications (p = 0.0031, OR = 0.2 (CI: 0.08–0.87)). Following ordinal regression, PPN and early oral tolerance showed a protective effect, being less likely to develop complications or to move from minor to major complications. In patients with low compliance to ERAS during the first postoperative day, PPN showed a protective effect, preventing 28% of morbidity. Conclusions: Perioperative peripheral parenteral nutrition (PPN) support with Peri-Olimel N4-E in colorectal cancer surgery associated with early oral intake could reduce postoperative complications.

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Laparoscopic colorectal cancer surgery combined with enhanced recovery after surgery protocol (ERAS) reduces the negative impact of sarcopenia on short-term outcomes

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2016.03.037 ◽

2016 ◽

Vol 42 (6) ◽

pp. 779-787 ◽

Cited By ~ 20

Author(s):

M. Pędziwiatr ◽

M. Pisarska ◽

P. Major ◽

A. Grochowska ◽

M. Matłok ◽

...

Keyword(s):

Colorectal Cancer ◽

Negative Impact ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Cancer Surgery ◽

Short Term ◽

Colorectal Cancer Surgery

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Assessment of Body Composition as an Indicator of Early Peripheral Parenteral Nutrition Therapy in Patients Undergoing Colorectal Cancer Surgery in an Enhanced Recovery Program

Nutrients ◽

10.3390/nu13093245 ◽

2021 ◽

Vol 13 (9) ◽

pp. 3245

Author(s):

Francisco López-Rodríguez-Arias ◽

Luis Sánchez-Guillén ◽

Cristina Lillo-García ◽

Verónica Aranaz-Ostáriz ◽

M José Alcaide ◽

...

Keyword(s):

Colorectal Cancer ◽

Body Composition ◽

High Risk ◽

Postoperative Complications ◽

Parenteral Nutrition ◽

Enhanced Recovery ◽

Low Risk ◽

Colorectal Cancer Surgery ◽

Enhanced Recovery Program ◽

Recovery Program

Background: A poor body composition (BC) has been identified as a risk factor for patients with colorectal cancer (CRC). This study was performed to assess the effect of early peripheral parenteral nutrition (PPN) on BC in patients undergoing CCR surgery within an enhanced recovery program. Methods: Patients with normal nutritional status were prospectively included between October 2016 and September 2019, randomized into two groups (PPN with periOlimel N4-E versus conventional fluid therapy) and subsequently classified according to their preoperative CT scan into high- or low-risk BC groups. Postoperative complications and length of hospital stay (LOS) were assessed. Results: Of the 156 patients analyzed, 88 patients (56.4%) were classified as having high-risk BC according to CT measurements. PPN led to a 15.4% reduction in postoperative complications in high-risk vs. 1.7% in low-risk BC patients. In the multivariate analysis, high-risk BC was related to an OR (95% CI) of 2 (p = 0.044) of presenting complications and of 1.9 (p = 0.066) for major complications, and was associated with an increase in LOS of 3.6 days (p = 0.039). Conclusions: The measurement of patients’ BC can allow for the identification of target patients where PPN has been proven to be an effective tool to improve postoperative outcomes.

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