Nutrition interventions in patients with gynecological cancers requiring surgery

Obermair, Andreas, Simunovic, Marko, Isenring, Liz and Janda, Monika (2017) Nutrition interventions in patients with gynecological cancers requiring surgery. Gynecologic Oncology, . doi:10.1016/j.ygyno.2017.01.028


Author Obermair, Andreas
Simunovic, Marko
Isenring, Liz
Janda, Monika
Title Nutrition interventions in patients with gynecological cancers requiring surgery
Journal name Gynecologic Oncology   Check publisher's open access policy
ISSN 1095-6859
0090-8258
Publication date 2017-02-04
Year available 2017
Sub-type Article (original research)
DOI 10.1016/j.ygyno.2017.01.028
Open Access Status Not yet assessed
Total pages 8
Place of publication Maryland Heights, MO United States
Publisher Academic Press
Collection year 2018
Language eng
Formatted abstract
Objective

Including developing countries, between 20 and 88% of gynecological oncology patients may present with at least mild malnutrition at diagnosis. Significant morbidity and mortality is attributed to malnutrition. Here we reviewed randomized clinical trials of nutritional interventions used to achieve early return to oral diet, enhance recovery from surgery and reduce adverse events in gynecological cancer patients undergoing surgery.

Methods

Ebscohost (CINAHL + Medline + PsycINFO), Cochrane, Embase, PubMed and Scopus databases were searched for articles published from 2000 onwards. Potentially eligible articles were screened by two reviewers. Length of hospital stay (LOS), postoperative complications, recovery of intestinal function, quality of life (QOL), hematological and immunological parameters were outcome measures of the nutritional interventions.

Results

Seven randomized clinical trials were included in the review. Early clear liquid diet, semiliquid diet, regular diet or immune-enhanced enteral diets were all found to be safe as nutritional interventions. In five of the seven trials significantly better outcomes were observed in the intervention group compared to usual care for one of more of the outcomes intestinal recovery time, LOS, postoperative complications and immunological parameters. However, the nutritional interventions varied greatly between the trials, making it difficult to directly compare their findings. Trial quality was low to moderate. Recommended malnutrition screening and assessment tools and guidelines for treatment are reviewed.

Conclusions

From the limited findings it would appear that nutritional interventions of early oral feeding and enteral feeding are safe. Receiving nutritional interventions seems to reduce LOS, intestinal recovery time and postoperative complications for some patients. Increasing use of neoadjuvant treatment may reduce the prevalence of patients presenting malnourished for surgery in the future.
Keyword Gynecological cancer
Length of hospital stay
Malnutrition
Nutritional intervention
Randomized clinical trial
Surgical outcomes
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
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Created: Tue, 21 Feb 2017, 00:20:20 EST by Web Cron on behalf of School of Medicine