Effect Of Preoperative Oral Nutrition Supplementation On Enhanced Recovery After Surgery Of Suspected Or Moderately Malnourished Patients With Gastric Cance

Objective: This study was designed to investigate the preoperative application of oral nutritional supplementation(ONS)in patients with suspected or moderately malnourished gastric cancer,and to observe the postoperative nutritional status,early activity tolerance,and incidence of complications after implementing the accelerated rehabilitation surgical concept.The effect of hospitalization time to optimize the perioperative nutritional support treatment program for accelerated gastric cancer accelerated surgery(ERAS),accelerate patient recovery and improve patient quality of life.Methods: This study selected 100 patients with gastrointestinal surgery admitted to a top three hospital in Jilin Province to have a subjective overall assessment(PG-SGA)score of grade B(suspicious or moderately malnourished)gastric cancer patients,randomly divided into observation group(50 cases)and Control group(50 cases).The observation group was given 3~7 days of ONS + regular diet education before surgery.The control group adopted traditional nutrition management methods and pre-operative regular diet education.After the preoperative preparation,the observation group and the control group were treated perioperatively according to the ERAS procedure.The changes of laboratory nutrition related indexes of albumin(ALB),prealbumin(PA)and retinol binding protein(RBP)on day 1st,2nd day and 4th day after operation were observed.The impact of early activity tolerance,incidence of complications,and length of hospital stay.Results:(1)A total of 100 patients with gastric cancer were included in the study.There were50 patients in the observation group and the control group.The differences in gender,age,admission weight,BMI,PG-SGA score,ALB,PA,RBP,surgical procedure,and TNM staging were compared between the two groups.None of them were statistically significant(P>0.05)and were comparable.(2)The difference of ALB,PA and RBP on the 1st day after operation was statistically significant(P<0.05).There was no significant difference in ALB,PA and RBP on the 2ndand 4th day after operation(P> 0.05),the postoperative ALB,PA,RBP levels were lower than the preoperative,ALB,PA,RBP decreased significantly on the first day after operation,the control group decreased significantly compared with the observation group,the observation group 2 days after the operation of ALB,PA,RBP Both of them decreased to a low peak.The control group decreased to a low peak on the second day after operation.The overall postoperative ALB,PA,and RBP levels were higher in the observation group than in the control group.(3)The scores of postoperative malnutrition in the two groups were higher than those in the control group,and the difference was statistically significant(P<0.05).(4)The activity tolerance of the two groups on the 1st,2nd,and 4th postoperative days was statistically significant(P<0.05).(5)There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).(6)There was no significant difference in postoperative hospital stay between the two groups(P>0.05).Conclusion:(1)Preoperative ONS can improve the nutritional status of patients with suspected or moderately malnourished gastric cancer.(2)Preoperative ONS improved early postoperative tolerance in patients with suspected or moderately malnourished gastric cancer.(3)Preoperative ONS did not reduce the incidence of suspected or moderately malnourished gastric cancer postoperative recent complications and shorten the postoperative hospital stay.