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Perioperative Nutrition and Enhanced Recovery after Surgery in Gastro-Intestinal Cancer Patients.

Malnutrition is a frequent problem in cancer patients, the prevalence and degree of which primarily depend on tumor stage and site. Preoperative malnutrition in surgical patients is associated with a prolonged hospital stay, more postoperative complications, higher re-admission rates and a higher incidence of postoperative death.

Given the focus on the cancer and its cure, nutrition is often neglected or under evaluated, despite the availability of international guidelines for nutritional care in cancer patients and the evidence that nutritional deterioration negatively affects survival. Many malnourished patients still do not receive adequate nutritional support from health professionals.

Inadequate nutritional support for cancer patients should be considered ethically unacceptable; prompt nutritional support must be guaranteed to all cancer patients, as it can bring many clinical and economic advantages.

The ERAS Coalition have produced the position paper “Perioperative nutrition and enhanced recovery after surgery in gastro-intestinal cancer patients”. The ERAS Coalition is composed of 2 representatives from ESSO, Sergio Sandrucci (IT) (ESSO Taskforce lead and main author of the position paper) and Geerard Beets (NL), a representative from the ERAS Society, Nicolas Demartines (CH), a representative from EAHPB, Kees de Jong (NL), a representative from Medtronic, Frank Ottinger, and a representative from Nutricia (also corporate sponsor of ESSO), Niki Georgiou.

The development of a position paper is intended to emphasize the importance of preoperative nutritional status on the short-term outcomes of an ERAS programme for gastrointestinal cancer surgery, in order to favor the incorporation of nutritional issues and ERAS philosophy in daily practice. 

Among the different aspects of perioperative management, the key issues for a best practice approach to gastrointestinal surgical oncology patients must be nutrition assessment, frailties management, prehabilitation and minimally invasive surgery.

The Executive Summary presents in a simple language the key points that the task force wants to stress for an optimal approach to the oncologic surgical patient promoting nutritional assessment and perioperative nutrition with and without enhanced recovery programme. The Executive Summary may be easily used to raise awareness among various stakeholders at policy level. The full scientific paper has be submitted to EJSO.

 

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