Perioperative total parenteral nutrition in malnourished, gastrointestinal cancer patients: A randomized, clinical trial

Federico Bozzetti, Cecilia Gavazzi, Rosalba Miceli, Nicoletta Rossi, Luigi Mariani, Luca Cozzaglio, Giuliano Bonfanti, Sabrina Piacenza

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Clinical trials investigating the potential benefits of perioperative total parenteral nutrition (TPN) for reducing the risk of surgery in malnourished cancer patients have yielded controversial results. Methods: Ninety elective surgical patients with gastric or colorectal tumors and weight loss of 10% or more of usual body weight were randomly assigned to 10 days of preoperative and 9 days of postoperative nutrition vs a simple control group. The daily per kilogram body weight TPN regimen included 34.6 ± 6.3 kcal nonprotein and 0.25 ± 0.04 g nitrogen per kilogram in a volume of 42.6 ± 7.3 mL of fluid. The glucose-to-fat calorie ratio was 70:30. Control patients did not receive preoperative nutrition but received 940 kcal nonprotein plus 85 g amino acids postoperatively. Results: Complications occurred in 37% of the patients receiving TPN vs 57% of the control patients (p = .03). Noninfectious complications mainly accounted for this difference, which was 12% vs 34%, respectively (p = .02). Mortality occurred in only 5 of the control group patients (p = .05). The total length of hospitalization for TPN patients was longer than for control (p = .00), whereas the length of postoperative stay in the two groups did not differ significantly. Conclusions: This study shows that 10 days of preoperative TPN that is continued postoperatively is able to reduce the complication rate by approximately one third and to prevent mortality in severely malnourished patients with gastrointestinal cancer.

Original languageEnglish
Pages (from-to)7-14
Number of pages8
JournalJournal of Parenteral and Enteral Nutrition
Volume24
Issue number1
Publication statusPublished - 2000

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

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