Significance of Preoperative Nutritional Risk Screening in Perioperative Nutrition Support for Colon Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHULei ¹ , HUSong ¹ , XUHua ² , MUChun-lu ¹ , ZHAOYang ¹ , WENZi-jun ¹

1. Department of General Surgery, Liao He Oil Center Hospital, Panjin 124010, Liaoning Province, China;
2. Department of Clinical Laboratory, Liao He Oil Center Hospital, Panjin 124010, Liaoning Province, China;

Corresponding author：

ZHULei, Email: zhulei19862012@126.com

Keywords：

Rectal cancer; Adjuvant chemotherapy; Meta-analysis

DOI：

10.7507/1007-9424.20150179

Video：

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Objective To investigate the guidance of preoperative nutritional risk screening in perioperative nutrition support for colon cancer, in order to provide evidence for the rationally clinical application of nutrition support. Methods Nutritional risk screening was carried out in 95 hospitalized patients with colon cancer who were treated in the Liao He Oil Center Hospital from Jul. 2012 to Jul. 2014, with the nutritional risk screening 2002 score summary table. Patients were divided into nutritional risk group and non-nutritional risk group according to the screening results, and postoperative bowel function recovery and nutritional indicators were compared between patients who received perioperative nutrition support according to the screening results and those who did not. Results There were 29 patients received perioperative nutrition support among 53 patients at nutritional risk and 19 patients received perioperative nutrition support among 42 patients without nutritional risk. Among 53 patients at nutritional risk, the time to first flatus, time to first defecation, hospital stay, postoperative complications rate, and postoperative recurrence/metastasis rate of patients who received perioperative nutrition support were shorter or lower than those of patients who didn't receive perioperative nutrition support (P<0.05), but there was no significant difference in mortality (P≥0.05); in addition, the levels of albumin, prealbumin, and transferring on 7-day after surgery were all higher in patients received perioperative nutrition support (P<0.05). Among 42 patients without nutritional risk, there was no significant difference in time to first flatus, time to first defecation, hospital stay, postoperative complications rate, postoperative recurrence/metastasis rate, and levels of albumin, prealbumin, and transferring on 1- and 7-day after surgery between patients received perioperative nutrition support and those who did not (P>0.05). Conclusions It is important to evaluate the nutritional risk in hospitalized patients with colon cancer. Nutritional support is benefical to the patients with nutritional risk, but it isn't necessary to patients without nutritional risk.

Citation： ZHULei, HUSong, XUHua, MUChun-lu, ZHAOYang, WENZi-jun. Significance of Preoperative Nutritional Risk Screening in Perioperative Nutrition Support for Colon Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(6): 700-704. doi: 10.7507/1007-9424.20150179 Copy

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2.	Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr, 2003, 22(4):415-421.
3.	Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002):a new method based on an analysis of controlled clinical trials. Clin Nutr, 2003, 22(3):321-336.
4.	Fettes SB, Davidson HI, Richardson RA, et al. Nutritional status of elective gastrointestinal surgery patients pre- and post-operatively. Clin Nutr, 2002, 21(3):249-254.
5.	李智, 张雅玲, 汪晓东, 等. NRS-2002评估术前不同营养状态对结直肠癌患者生存质量的影响. 中国普外基础与临床杂志, 2014, 21(1):41-45.
6.	贾震易, 秦环龙. 胃肠肿瘤患者营养风险与营养支持调查分析. 中国普外基础与临床杂志, 2011, 18(12):1254-1258.
7.	吴国豪. 恶性肿瘤患者营养不良的原因及防治对策. 中华胃肠外科杂志, 2010, 13(3):170-172.
8.	Lochs H, Pichard C, Allison SP. Evidence supports nutritional support. Clin Nutr, 2006, 25(2):177-179.
9.	Zhu QL, Feng B, Lu AG, et al. Laparoscopic low anterior resection for rectal carcinoma:complications and management in 132 consecutive patients. World J Gastroenterol, 2010, 16(36):4605-4610.
10.	康欣, 胡毅, 杨涌, 等. 胃肠道大手术患者营养风险筛查及营养支持效果对比研究. 中国普外基础与临床杂志, 2014, 21(10):1259-1263.
11.	Schwegler I, von Holzen A, Gutzwiller JP, et al. Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer. Br J Surg, 2010, 97(1):92-97.
12.	Drescher T, Singler K, Ulrich A, et al. Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients. Eur J Clin Nutr, 2010, 64(8):887-893.
13.	Hendry PO, Hausel J, Nygren J, et al. Determinants of outcome after colorectal resection within an enhanced recovery programme. Br J Surg, 2009, 96(2):197-205.
14.	Bovio G, Montagna G, Bariani C, et al. Upper gastrointestinal symptoms in patients with advanced cancer:relationship to nutritional and performance status. Support Care Cancer, 2009, 17(10):1317-1324.
15.	Fanali G, di Masi A, Trezza V, et al. Human serum albumin:from bench to bedside. Mol Aspects Med, 2012, 33(3):209-290.
16.	Grass F, Cerantola Y, Schäfer M, et al. Perioperative nutrition is still a surgical orphan:results of a Swiss-Austrian survey. Eur J Clin Nutr, 2011, 65(5):642-647.
17.	Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival:a systematic review of the epidemiological literature. Nutr J, 2010, 9:69-85.
18.	Shim H, Cheong JH, Lee KY, et al. Perioperative nutritional status changes in gastrointestinal cancer patients. Yonsei Med J, 2013, 54(6):1370-1376.
19.	Schiesser M, Müller S, Kirchhoff P, et al. Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgery. Clin Nutr, 2008, 27(4):565-570.
20.	刘洪, 胡彦锋, 刘浩, 等. 术前营养风险评分与直肠癌前切除术后吻合口瘘的关系. 中华胃肠外科杂志, 2013, 16(6):552-554.
21.	Schiesser M, Kirchhoff P, Müller MK, et al. The correlation of nutrition risk index, nutrition risk score, and bioimpedance analysis with postoperative complications in patients undergoing gastrointestinal surgery. Surgery, 2009, 145(5):519-526.
22.	Kwag SJ, Kim JG, Kang WK, et al. The nutritional risk is a independent factor for postoperative morbidity in surgery for colorectal cancer. Ann Surg Treat Res, 2014, 86(4):206-211.
23.	La Torre M, Ziparo V, Nigri G, et al. Malnutrition and pancreatic surgery:prevalence and outcomes. J Surg Oncol, 2013, 107(7):702-708.
24.	Grass F, Hübner M, Schäfer M, et al. Preoperative nutritional screening by the specialist instead of the nutritional risk score might prevent excess nutrition:a multivariate analysis of nutritional risk factors. Nutr J, 2015, 14(1):37-45.
25.	Putwatana P, Reodecha P, Sirapo-Ngam Y, et al. Nutrition screening tools and the prediction of postoperative infectious and wound complications:comparison of methods in presence of risk adjustment. Nutrition, 2005, 21(6):691-697.
26.	Faramarzi E, Mahdavi R, Mohammad-Zadeh M, et al. Validation of nutritional risk index method against patient-generated subjective global assessment in screening malnutrition in colorectal cancer patients. Chin J Cancer Res, 2013, 25(5):544-548.

1. Akbulut G. New perspective for nutritional support of cancer patients:enteral/parenteral nutrition. Exp Ther Med, 2011, 2(4):675-684.
2. Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr, 2003, 22(4):415-421.
3. Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002):a new method based on an analysis of controlled clinical trials. Clin Nutr, 2003, 22(3):321-336.
4. Fettes SB, Davidson HI, Richardson RA, et al. Nutritional status of elective gastrointestinal surgery patients pre- and post-operatively. Clin Nutr, 2002, 21(3):249-254.
5. 李智, 张雅玲, 汪晓东, 等. NRS-2002评估术前不同营养状态对结直肠癌患者生存质量的影响. 中国普外基础与临床杂志, 2014, 21(1):41-45.
6. 贾震易, 秦环龙. 胃肠肿瘤患者营养风险与营养支持调查分析. 中国普外基础与临床杂志, 2011, 18(12):1254-1258.
7. 吴国豪. 恶性肿瘤患者营养不良的原因及防治对策. 中华胃肠外科杂志, 2010, 13(3):170-172.
8. Lochs H, Pichard C, Allison SP. Evidence supports nutritional support. Clin Nutr, 2006, 25(2):177-179.
9. Zhu QL, Feng B, Lu AG, et al. Laparoscopic low anterior resection for rectal carcinoma:complications and management in 132 consecutive patients. World J Gastroenterol, 2010, 16(36):4605-4610.
10. 康欣, 胡毅, 杨涌, 等. 胃肠道大手术患者营养风险筛查及营养支持效果对比研究. 中国普外基础与临床杂志, 2014, 21(10):1259-1263.
11. Schwegler I, von Holzen A, Gutzwiller JP, et al. Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer. Br J Surg, 2010, 97(1):92-97.
12. Drescher T, Singler K, Ulrich A, et al. Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients. Eur J Clin Nutr, 2010, 64(8):887-893.
13. Hendry PO, Hausel J, Nygren J, et al. Determinants of outcome after colorectal resection within an enhanced recovery programme. Br J Surg, 2009, 96(2):197-205.
14. Bovio G, Montagna G, Bariani C, et al. Upper gastrointestinal symptoms in patients with advanced cancer:relationship to nutritional and performance status. Support Care Cancer, 2009, 17(10):1317-1324.
15. Fanali G, di Masi A, Trezza V, et al. Human serum albumin:from bench to bedside. Mol Aspects Med, 2012, 33(3):209-290.
16. Grass F, Cerantola Y, Schäfer M, et al. Perioperative nutrition is still a surgical orphan:results of a Swiss-Austrian survey. Eur J Clin Nutr, 2011, 65(5):642-647.
17. Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival:a systematic review of the epidemiological literature. Nutr J, 2010, 9:69-85.
18. Shim H, Cheong JH, Lee KY, et al. Perioperative nutritional status changes in gastrointestinal cancer patients. Yonsei Med J, 2013, 54(6):1370-1376.
19. Schiesser M, Müller S, Kirchhoff P, et al. Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgery. Clin Nutr, 2008, 27(4):565-570.
20. 刘洪, 胡彦锋, 刘浩, 等. 术前营养风险评分与直肠癌前切除术后吻合口瘘的关系. 中华胃肠外科杂志, 2013, 16(6):552-554.
21. Schiesser M, Kirchhoff P, Müller MK, et al. The correlation of nutrition risk index, nutrition risk score, and bioimpedance analysis with postoperative complications in patients undergoing gastrointestinal surgery. Surgery, 2009, 145(5):519-526.
22. Kwag SJ, Kim JG, Kang WK, et al. The nutritional risk is a independent factor for postoperative morbidity in surgery for colorectal cancer. Ann Surg Treat Res, 2014, 86(4):206-211.
23. La Torre M, Ziparo V, Nigri G, et al. Malnutrition and pancreatic surgery:prevalence and outcomes. J Surg Oncol, 2013, 107(7):702-708.
24. Grass F, Hübner M, Schäfer M, et al. Preoperative nutritional screening by the specialist instead of the nutritional risk score might prevent excess nutrition:a multivariate analysis of nutritional risk factors. Nutr J, 2015, 14(1):37-45.
25. Putwatana P, Reodecha P, Sirapo-Ngam Y, et al. Nutrition screening tools and the prediction of postoperative infectious and wound complications:comparison of methods in presence of risk adjustment. Nutrition, 2005, 21(6):691-697.
26. Faramarzi E, Mahdavi R, Mohammad-Zadeh M, et al. Validation of nutritional risk index method against patient-generated subjective global assessment in screening malnutrition in colorectal cancer patients. Chin J Cancer Res, 2013, 25(5):544-548.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Significance of Preoperative Nutritional Risk Screening in Perioperative Nutrition Support for Colon Cancer

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