Summary:
Background. The aim of this retrospective analysis was the evaluation of the effect of parenteral
nutrition before surgery in malnourished patients on the reduction of risks during postoperative period
after upper gastrointestinal tract resection. 57 patients with the diagnosis of oesophageal or stomach
carcinoma were included into the selected group. Patients were divided into three groups: I. group:
resecabile tumor, parenteral nutrition, malnutrition, II. group: nonresecabile tumor, parenteral nutrition,
malnutrition, III. group: resecabile tumor, without parenteral nutrition, well nourished.
Methods and Results. In the group of malnourished patients, seven days after the applied parental
nutrition, a statistical significant difference in the elevated values of proteins (I.: 62 ± 3.8→70 ± 1.75,
II.: 59.7 ± 3.2→69.2 ± 1.2) and albumin (I: 32.6 ± 1.95→38.0 ± 1.09, II.: 31.1 ± 1.2→37.5 ± 0.9)
p < 0.001 were achieved. Complications associated with the insertion of central venous catheter
decreased as follows: plugged catheter (17.6%), local erythema (7.5%), pneumothorax (5%),
phlebotrombosis (5%), haemothorax (0.4%). Postoperative complications did not achieve statistical
significance (p < 0,05) in the groups I.–III. The highest incidence of wound and anastomosis
dehiscention and sepsis was noticed in the first group, the lowest in the third group. Brochopneumonia
had the highest occurrence in the second group, the lowest in the third group.
Conclusions. Preoperative parenteral nutrition as a prevention of complications after resection surgery
on stomach and oesophagus is beneficial in the middle and high grade of malnourished patients, despite
of higher costs and prolonged hospitalization, considering the comparable percentage of postoperative
complications in the group of non-malnourished and malnourished patients. The nutritional
supplementation should take at least seven days.
Key words:
parenteral nutrition, preoperative preparation, malnutrition, carcinoma of upper
gastrointestinal tract.
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