Preoperative non-selective administration of nutritional supplements to patients undergoing elective colorectal resection - standard of perioperative care?

ABSTRACT

INTRODUCTION: Preoperative nutritional support for oncosurgical patients is recommended to minimize the negative effects of potential malnutrition. Nutritional support is intended to adjust the pathophysiological reactions to surgery, reduce postoperative complications, shorten the length of hospital stay and speed up convalescence. The aim of the present study was to evaluate the effect of preoperative nutritional supplements (ONS oral nutritional supplements) on the physical and nutritional status of patients undergoing elective colorectal resection for cancer and to assess patients self-sufficiency after surgery. METHODS: This was a prospective, randomized, single-center clinical trial designed to assess self-sufficiency and return to normal activities in relation to preoperative ONS in patients undergoing elective colorectal surgery. Patients enrolled in the study were randomized to receive ONS twice daily for 7 days prior to surgery or no ONS. RESULTS: One hundred patients were included in the study. The rate of postoperative complications was comparable; no differences were found in postoperative values of laboratory nutritional parameters (albumin, prealbumin). The length of hospital stay was comparable; the stay in the ICU was shorter in patients taking ONS but the difference was not statistically significant. Differences between the study subgroups regarding muscle weight were not statistically significant. Patient self-sufficiency (assessed using the Barthel index) was comparable in both groups before and after surgery (p=0.717 and p=0.327). CONCLUSION: Non-selective preoperative administration of ONS to all patients undergoing elective colorectal resection does not reduce postoperative morbidity or speed up recovery. Patients self-sufficiency and their physical and nutritional status are not affected by preoperative nutritional support.