scholarly journals Effect of Early Peripheral Parenteral Nutrition Support in an Enhanced Recovery Program for Colorectal Cancer Surgery: A Randomized Open Trial

2021 ◽  
Vol 10 (16) ◽  
pp. 3647
Author(s):  
Luis Sánchez-Guillén ◽  
Leticia Soriano-Irigaray ◽  
Francisco López-Rodríguez-Arias ◽  
Xavier Barber ◽  
Ana Murcia ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Parenteral Nutrition ◽  
Protective Effect ◽  
Enhanced Recovery ◽  
Cancer Surgery ◽  
Colorectal Cancer Surgery ◽  
Enhanced Recovery Program ◽  
Major Complications ◽  
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.

scholarly journals 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 ◽  
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.

scholarly journals Center-Level Procedure Volume Does Not Predict Failure-to-Rescue After Severe Complications of Oncologic Colon and Rectal Surgery

2021 ◽  
Author(s):  
Miriam Lillo-Felipe ◽  
Rebecka Ahl Hulme ◽  
Maximilian Peter Forssten ◽  
Gary A. Bass ◽  
Yang Cao ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
High Volume ◽  
Cancer Surgery ◽  
Colon And Rectal Surgery ◽  
Surgical Volume ◽  
Failure To Rescue ◽  
Colorectal Cancer Surgery ◽  
Procedure Volume ◽  
Low Volume

Abstract Background The relationship between hospital surgical volume and outcome after colorectal cancer surgery has thoroughly been studied. However, few studies have assessed hospital surgical volume and failure-to-rescue (FTR) after colon and rectal cancer surgery. The aim of the current study is to evaluate FTR following colorectal cancer surgery between clinics based on procedure volume. Methods Patients undergoing colorectal cancer surgery in Sweden from January 2015 to January 2020 were recruited through the Swedish Colorectal Cancer Registry. The primary endpoint was FTR, defined as the proportion of patients with 30-day mortality after severe postoperative complications in colorectal cancer surgery. Severe postoperative complications were defined as Clavien–Dindo ≥ 3. FTR incidence rate ratios (IRR) were calculated comparing center volume stratified in low-volume (≤ 200 cases/year) and high-volume centers (> 200 cases/year), as well as with an alternative stratification comparing low-volume (< 50 cases/year), medium-volume (50–150 cases/year) and high-volume centers (> 150 cases/year). Results A total of 23,351 patients were included in this study, of whom 2964 suffered severe postoperative complication(s). Adjusted IRR showed no significant differences between high- and low-volume centers with an IRR of 0.97 (0.75–1.26, p = 0.844) in high-volume centers in the first stratification and an IRR of 2.06 (0.80–5.31, p = 0.134) for high-volume centers and 2.15 (0.83–5.56, p = 0.116) for medium-volume centers in the second stratification. Conclusion This nationwide retrospectively analyzed cohort study fails to demonstrate a significant association between hospital surgical volume and FTR after colorectal cancer surgery. Future studies should explore alternative characteristics and their correlation with FTR to identify possible interventions for the improvement of quality of care after colorectal cancer surgery.

scholarly journals Blood Galectin-3 Levels Predict Postoperative Complications after Colorectal Cancer Surgery

2019 ◽  
Vol 86 (3) ◽  
pp. 142-148 ◽  
Author(s):  
Akihisa Matsuda ◽  
Marina Yamada ◽  
Satoshi Matsumoto ◽  
Nobuyuki Sakurazawa ◽  
Youichi Kawano ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Cancer Surgery ◽  
Colorectal Cancer Surgery ◽  
Galectin 3

Prediction of postoperative complications based on biomarkers after elective colorectal cancer surgery

2019 ◽  
Vol 45 (2) ◽  
pp. e47
Author(s):  
T. Kohmura ◽  
J. Yasutomi ◽  
K. Kusashio ◽  
T. Suzuki ◽  
K. Fushimi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Cancer Surgery ◽  
Colorectal Cancer Surgery
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