Aug 2026· Annals of Nutrition and Metabolism· pp.
1
· 0 citations
Medicine
TL;DR
Serum micronutrient levels should be monitored carefully before and after gastrectomy, and supplementation should be provided as needed, particularly in TG.
This study demonstrates comparable and in some key indicators higher clinical and economic efficiency of domestic enteral nutrition products in perioperative period for cancer patients with nutritional disorders.
D. Grekov, S. S. Lebedev, A. M. Mikheeva et al.· Khirurgiia· 0 citations
In GC patients after antitumor treatment, the use of a semi-elemental enteral mixture as additional nutrition had advantages over standard polymer mixtures.
O. Obukhova, I. A. Kurmukov· Clinical Nutrition and Metab...· 0 citations
In colorectal cancer patients, malnutrition, sarcopenia, and even cachexia are highly prevalent (24–65%); those patients who undergo surgery with a compromised nutritional status tend to have more complications (OR: 1.84; 1.35–2.48). Therefore, proper nutritional management before surgery is essential. The principal therapeutic option for patients with colorectal cancer is surgery; in this way, these patients are vulnerable to a worse prognosis if a preoperative nutritional intervention is not considered. An individualized, well-designed nutrition care plan, as part of a multimodal therapeutic approach, that promotes adequate energy and protein intake to counteract catabolism and preserve muscle mass can help improve postoperative outcomes. Other strategies that may be useful for patients undergoing colorectal cancer surgery are immunonutrition and micronutrient supplementation. The combined use of certain immunonutrients, such as polyunsaturated fatty acids, branched-chain amino acids, arginine, glutamine, and nucleotides, has been suggested in some studies to help reduce surgery-related complications and infections, promote better wound healing, and shorten hospital stay after colorectal surgery. Certain micronutrients, such as vitamin C and zinc, can enhance the clinical effects of prior nutritional interventions and promote postoperative recovery. Nevertheless, limitations and mixed results in the current evidence preclude recommending these strategies in routine clinical practice. An individualized approach for each patient should be considered to improve surgical outcomes through nutrition.
F. Estrada-Moya, S. Ortiz-Gutiérrez, M. Guevara-Cruz et al.· Frontiers in Nutrition· 0 citations
BackgroundEarly postoperative energy intake after gastrectomy may be insufficient and may contribute to short-term weight loss, yet whether tolerating an oral diet within a standardized clinical pathway corresponds to adequate intake remains unclear. We examined early postoperative energy intake and its association with weight loss after gastrectomy.MethodsWe retrospectively assessed postoperative energy intake and weight loss in patients with pStage II-III gastric cancer who underwent distal gastrectomy at our hospital between January 2012 and December 2021. Multivariable analysis using multiple regression was performed to evaluate the association between postoperative energy intake and weight loss.ResultsThe median (interquartile range) weight loss was 2.5 (1.00-3.70) kg, corresponding to a reduction of 4.2% (1.9%-6.4%). Median energy intake was 1148 (987-1251) kcal/day, corresponding to 18.9 (15.0-21.9) kcal/kg/day based on body weight. The median oral intake rate was 81.5% (68.80-89.60) during postoperative days (PODs) 3-14 and 90.8% (78.65-98.20) during PODs 7-14. The multivariable analysis identified postoperative energy intake per body weight as a factor associated with weight loss (estimated regression coefficient = -0.18, 95% confidence interval [CI] = -0.27 to -0.09, P < .01). C-Reactive protein (CRP) level was also identified as a factor associated with weight loss (estimated regression coefficient = 0.14, 95% CI = 0.01-0.27, P = .039).DiscussionInsufficient early postoperative energy intake and elevated preoperative CRP were independently associated with weight loss after distal gastrectomy. Despite apparent oral feeding success within a standardized clinical pathway, "hidden underfeeding" persisted-particularly in larger patients-warranting individualized nutritional supplementation strategies.
Kota Taketani, Haruna Furukawa, Takeshi Saijo et al.· The American surgeon· 0 citations
Background: Nutritional deterioration is a common consequence of gastrectomy for gastric cancer and may persist despite standardized perioperative care. However, prospective longitudinal evidence describing the early course of postoperative nutritional recovery remains limited. This study aimed to characterize nutritional recovery trajectories following curative gastrectomy and to evaluate the influence of the extent of gastric resection on postoperative recovery. Methods: A prospective cohort of 239 consecutive patients undergoing curative-intent subtotal or total gastrectomy for gastric adenocarcinoma was followed between January 2022 and December 2025. The longitudinal complete-case analysis included 217 patients with available assessments at all three predefined time points: preoperatively (T0), at hospital discharge (T1), and three months after surgery (T3). Nutritional–immune biomarker trajectories were assessed preoperatively (T0), at hospital discharge (T1), and three months after surgery (T3) using serum albumin, total cholesterol, absolute lymphocyte count, and the Controlling Nutritional Status (CONUT) score. Longitudinal changes were evaluated using linear mixed-effects models with patient-specific random intercepts. Results: All evaluated nutritional–immune biomarkers changed significantly in an adverse direction after surgery, reaching their most unfavorable values at hospital discharge (all p < 0.001), followed by partial biochemical recovery at three months. Because albumin, lymphocyte count, and CONUT are influenced by the acute inflammatory and metabolic response to surgery, the discharge changes should not be interpreted as direct evidence of acute malnutrition. Nevertheless, none of the evaluated biomarkers returned to its preoperative value. Recovery between discharge and three months represented 65.6% of the initial decline for serum albumin, 50.5% for absolute lymphocyte count, 51.7% for total cholesterol, and 60.9% for the CONUT score. After adjustment for age, sex, neoadjuvant chemotherapy, baseline body mass index, ASA status, pathological T3–T4 stage, and major postoperative morbidity, total gastrectomy was associated with a greater early decline in absolute lymphocyte count at hospital discharge (β = −165.7 cells/mm3; 95% CI, −204.9 to −126.6; p < 0.001). This difference was no longer present at three months (p = 0.955). No significant time-by-gastrectomy interactions were observed for albumin, cholesterol, or corrected CONUT. Conclusions: Nutritional recovery following gastrectomy is a dynamic and prolonged process characterized by marked early nutritional–inflammatory biomarker changes and incomplete biochemical restoration at three months. Resection extent was not independently associated with persistently less favorable albumin, cholesterol, or corrected CONUT trajectories. The findings describe early biochemical changes and should not be extrapolated to body composition, functional recovery, micronutrient status, quality of life, or long-term survivorship. These findings apply primarily to patients who survived and completed the three-month follow-up.
OBJECTIVE
We aimed to describe the prevalence of preoperative micronutrient abnormalities, protein-energy malnutrition (PEM), and their association with postoperative complications in patients undergoing head and neck free flap reconstruction (HNFFR).
METHODS
A single institution, retrospective cohort study of adults requiring HNFFR was performed. Patient data and pre-operative serological parameters were extracted from the electronic medical record. Nutritional status was assessed by the Patient Generated-Subjective Global Assessment (PG-SGA) tool.
RESULTS
About 261 patients met inclusion criteria with the predominant undergoing surgery involving the oral cavity (n = 203; 77.8%). The combined prevalence of moderate and severe malnutrition was 27.2%. Hypovitaminosis C was present in 64 patients (36.8%) and was associated with an increased likelihood of a complication on both univariate (OR 1.9 [1.01-3.51; 95% CI]) and multivariate (OR 2.2 [1.12-4.29; 95% CI]) analysis. On further subgroup univariate analysis, increased age, hypertension, macrocytosis, PG-SGA score and moderate malnutrition were associated with postoperative medical complications. An increased length of stay was also associated with complications on univariate and multivariate analysis.
CONCLUSION
Hypovitaminosis C was associated with an increased risk of postoperative complications. Early screening and intervention for micronutrient depletion and PEM prior to surgery may reduce these risks for patients undergoing HNFFR.
LEVEL OF EVIDENCE: 3
Dong Tony Cheng, Shane McAuliffe, Nazy Zarshenas et al.· The Laryngoscope· 0 citations
We use cookies to run the site and, with your consent, for analytics and to show ads.
See our Cookie Policy.
