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Original Article
- Risk of Malnutrition after Gastrointestinal Cancer Surgery: A Propensity Score Matched Retrospective Cohort Study
- Sung-Hoon Yoon, Bong-Hyeon Kye, Hyung-Jin Kim, Kyong-Hwa Jun, Hyeon-Min Cho, Hyung-Min Chin
- Surg Metab Nutr 2018;9(1):16-25. Published online June 30, 2018
- DOI: https://doi.org/10.18858/smn.2018.9.1.16
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Abstract
PDF
ePub Purpose:
Patients with cancers arising from the gastrointestinal tract can suffer from nutritional inadequacies caused by various factors. This study investigated the risk of malnutrition after curative surgery in patients with gastric cancer (GC) or colorectal cancer (CRC) using various preoperative and postoperative nutritional screening tools.
Materials and Methods:
In the authors’ hospital, 407 patients (206 patients with GC and 201 patients with CRC) underwent surgery between July 2011 and June 2012. The patients from the two groups were matched using the propensity score and then analyzed the nutritional data from 170 patients (85 patients in each group), retrospectively.
Results:
In both groups, the postoperative nutritional status was impaired significantly compared to the preoperative status. The postoperative risk of undernutrition in CRC patients was significantly lower than that of the GC patients according to the Malnutrition Universal Screening Tool (P=0.007). At the time of hospital discharge after surgery, the incidence of a lower serum albumin level (P=0.002) and more than 5% weight loss (P=0.013) were higher in the GC group than in the CRC group. A comparison of the postoperative nutritional status among the types of surgery in each group, total gastrectomy in the GC group (P=0.015) and proctectomy with diverting stoma in the CRC group (P=0.06), were related to more than 5% weight loss.
Conclusion:
Gastrointestinal cancer surgery might increase the patients’ postoperative risk of malnutrition, particularly in GC surgery. Therefore, consecutive assessments of the nutritional status and appropriate nutritional support are necessary after surgery for GC and CRC.
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Review Article
- Nutritional Supports in Patients with Inflammatory Bowel Disease
- Bong-Hyeon Kye
- J Clin Nutr 2016;8(1):11-18. Published online April 30, 2016
- DOI: https://doi.org/10.15747/jcn.2016.8.1.11
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Abstract
PDFePub
Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease (IBD). In addition, a significant number of children with IBD, particularly Crohn’s disease (CD) have impaired linear growth. Nutritional support is important in patients with IBD and nutritional problems. Enteral nutrition (EN) can reduce CD activity and maintain remission in both adults and children. Given that the ultimate goal in the treatment of CD is mucosal healing, this advantage of EN over corticosteroid treatment is valuable in therapeutic decision-making. EN is indicated in active CD, in cases of steroid intolerance, in patient’s refusal of steroids, in combination with steroids in undernourished individuals, and in patients with inflammatory stenosis of the small intestine. EN should be the first choice compared to total parenteral nutrition. However, EN does not have a primary therapeutic role in ulcerative colitis. In conclusion, it appears that the role of nutrition as supportive care in patients with IBD should not be underestimated. The aim of this comprehensive review is to provide the reader with an update on the role of nutritional support in IBD patients.
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