ORIGINAL ARTICLES   

Chirurgia 2016 June;29(3):65-8

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Preoperative immunonutrition: how to insert in daily practice scientific evidence

Annalisa ALESSIATO, Elena TRINCHERO, Maria L. AMERIO

SOC of Dietetics and Clinical Nutrition, Cardinal Massaia Hospital, Asti, Italy

BACKGROUND: The Complex Structure of Dietetics and Clinical Nutrition in Cardinal Massaia Hospital of Asti activated the protocol of preoperative nutrition for cancer patients undergoing head and neck major surgery and abdominal elective surgery, aimed at optimizing the timing of the immunonutritional intervention and at encouraging better patient compliance.
METHODS: The patients undergoing gastrointestinal or head-neck surgery are sent to our division’s clinic dedicated to prehospitalization immunonutritional visit, where the Dietitian does a nutritional visit and the nutritional équipe prescribes immunonutrional therapy. Between December 2011 and September 2014, 299 patients were examined: 180 males and 119 females. Age: 68.7±7.5 years (average±SD); weight: 73.1±9.4 kg; height: 1.65±0.05 m; BMI: 26.9±3.3 kg/m2. Normonurished patients: 155; malnourished patients or at risk of malnutrition: 144. Cancer localization: colorectal 220 pts; gastric 35 pts, esophagus 2 pts, pancreas 8 pts, kidney 1 pt, liver 3 pts, head and neck 20 pts, 10 patients reoperated for metastasis.
RESULTS: Compliance to the immunonutritional treatment: 95.3%. Weight at discharge: 71,8±8.7 kg (average±SD); BMI: 26.7±2.9 kg/m2. Absence of complications in 242 pts. Presence of complications in 57 pts, 37 infective and 32 non-infective. Nutritional treatment at discharge: os 270 pts; os + supplements: 19 pts, os + NPD or NPD or NED: 10 pts.
CONCLUSIONS: Our experience shows the feasibility of the nutritional preoperative intervention at home for patients undergoing cancer surgery.