The impact of the preoperative nutritional preparation in patients with colorectal cancer on incidence of anastomotic leak
| العنوان: | The impact of the preoperative nutritional preparation in patients with colorectal cancer on incidence of anastomotic leak |
|---|---|
| المؤلفون: | Mužina Mišić, Dubravka |
| المساهمون: | Zovak, Mario, Patrlj, Leonardo, Krznarić, Željko, Augustin, Goran |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | nutritional preparation, anastomotic dehiscence, colon cancer, malnutrition, early diagnosis |
| الوصف: | U ovom istraživanju proučavala se povezanost prijeoperacijske nutritivne pripreme s visokoproteinskim nutritivnim pripravcima kod bolesnika s operabilnim rakom debelogacrijeva s pojavom dehiscencije crijevne anastomoze. Postavljena je hipoteza da će bolesnici koji su prije operacije pripremljeni s visokoproteinskim nutritivnim pripravcima imati manju učestalost dehiscencija anastomoze. Cilj istraživanja bio je ustanoviti povezanost prijeoperacijske nutritivne pripreme bolesnika rakom debeloga crijeva na učestalost dehiscencije crijevnih anastomoza. Dodatni ciljevi bili su utvrditi učestalost pothranjenost kod bolesnika s rakom debeloga crijeva, utvrditi da li prijeoperacijski nutritivni status bolesnika ima utjecaj na učestalost dehiscencija anastomoze i utvrditi da li je moguća ranija dijagnoza dehiscencija anastomoza mjerenjem vrijednosti serumskog CRP-a, te CRP-a i citokina( IL-6 i TNF-alpha) iz intraperitonealne tekućine prva četiri postoperacijska dana. Ukupan broj ispitanika bio je 100, koji su podijeljeni u dvije skupine. Prvu skupinu (N=50) su činili bolesnici s rakom debeloga crijeva koji primali, uz uobičajenu prehranu, i visokoproteinske nutritivne pripravke tijekom10 dana prije kirurškog zahvata, a drugu skupinu (N=50) bolesnici s rakom debelog crijeva koji su primali samo uobičajenu prehranu. Ustanovljeno je da su bolesnici koji su primali prijeoperacijski nutritivne pripravke imali statistički značajno manji broj dehiscencija anastomoze. Učestalost pothranjenosti kod ispitanika bila je 13%. Bolesnici koji su preoperativnim nutritivnim probirom okarakterizirani da su u nutritivnom riziku (NRS-2002 zbroj 3 i više) imali su više dehiscencija anastomoze. Bolesnici s hipoproteinemijom (ukupni serumski proteini manja od 66mg/L) i hipoalbuminemijom ( albumini manja od 35mg/L) imali su također veći broj dehiscencija. Mjerenje vrijednosti serumskog CRP-a, posebno 3. i 4.postoperacijski dan, pokazalo se kao najpouzdaniji marker rane dijagnostike dehiscencije anastomoze. Utvrdilo se da je mjerenje vrijednosti IL-6 i TNF-alpha u prva dva postoperacijska dana također dobar marker rane dijagnostike dehiscencije. Nutritivna priprema bolesnika s rakom debeloga crijeva, osobito kod bolesnika u nutritivnom riziku i kod pothranjenih bolesnika, mogla bi imati utjecaj na smanjenje učestalosti dehiscencije anastomoze kod takvih bolesnika, ali potrebna su daljnja istraživanja na većem broju ispitanika. In this research, we studied the correlation of preoperative nutritional preparation with high-protein enteral supplements in patients with colorectal cancer with occurence of anastomotic leakage. We set the hypothesis that patients who received preoperatively high-protein enteral supplements will have lower incidience of anastomotic leakage. Our goals were to determine the relationship between preoperative nutritional preparation in patients with colorectal cancer with incidence of anastomotic leakage.Also, we wanted to determine the incidence of malnutrition in patinets with colorectal cancer, the relationship between preoperative nutritive status of the patieents with incidence of anastomotic leakage and to determine the possibility od early diagnosis of anastomotic leakage with continuos measurement of serum CRP and CRP and cytokines (IL-6 and TNF-alpha) in intraperitoneal fluid. The total number of subjects was 100, divided into two groups. In the first group (N=50) were patients with colorecta cancer who received, with their usual diet, high-protein enteral supplement 10 days prior tothe surgery, while the second (N=50) group included patients with colorectal cancer who received only their usual diet. Anastomotic leakage was significantly lower in group of patients with preoperative nutritional preparation. The incidence of malnutrition was 13%. Patients with NRS-2002 score 3 and more had significantly higher incidence of anastomotic leakage.Patients with hypoproteinemia(serum protein levels lower than 66mg/L) and hypoalbuminemia (albumin levels lower than 35mg/L) had also higher incidence of anastomotic leakage. Measurement of serum CRP was a very usefull marker of early diagnosis od anastomotic leakage, especially on 3rd and 4th postoperative day. Levels of IL-6 and TNF-alpha can also be valuable markers in early diagnosis, on first two postoperative days. Nutritional preparation in patienst with colorectal cancer, especially in patients at nutritional risk and malnourished could lower the incidence of anastomotic leakage. However, larger studies should be conducted to confirm these findings. |
| وصف الملف: | application/pdf |
| اللغة: | Croatian |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=od______4137::44d296f7e64bcad3f5b73b64e052b0ab https://urn.nsk.hr/urn:nbn:hr:105:036115 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.od......4137..44d296f7e64bcad3f5b73b64e052b0ab |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |