Effects of a nutritional intervention in a fast-track program for a colorectal cancer surgery: systematic review

Carmina Wanden-Berghe, Javier Sanz-Valero, Antonio Arroyo-Sebastián, Kamila Cheikh-Moussa, Pedro Moya-Forcen

Resumen


Introducción: Preoperative nutritional status (NS) has consequences on postoperative (POSTOP) recovery. Our aim was to systematically review the nutritional interventions (NI) in Fast-Track protocols for colorectal cancer surgery and assess morbidity-mortality and patient´s recovery.

Method: Systematic review of scientific literature after consulting bibliographic databases: Medline, The Cochrane Library, Scopus, Embase, Web of Science, Institute for Scientific Information, Latin American and Caribbean Health Sciences Literature, The Cumulative Index to Nursing and Allied Health Literature. MeSH Descriptors: “Colorectal Surgery”, “Fast-Track”, “Perioperative Care”, “Nutrition Therapy” and “Enhanced recovery programme”. Filters: “Humans”, Adult (19+ years) and “Clinical Trial”. Variables POSTOP outcomes: bowel recovery (BR), hospital stay (HS), complications and death.

Results: Selected studies, 27, had good or excellent methodological quality. From 25 to 597 patients were included. Aged between 16-94 years, men were predominant in 66.6%. NS was evaluated in 13 studies; 7 by Body Mass Index while one by Subjective Global Assessment. One presented POSTOP data. Fast-Track groups had solids, liquids or supplements (SS) in prior 2-8 hours. SS were high in carbohydrates, immune-nutrients and non-residue. Free liquids, solids and SS intake was allowed in POSTOP. Half traditional groups fasted between 3-12 hours and resumed POSTOP food intake progressively.

Conclusions: Fast-Track groups had early BR (p < 0.01). Traditional groups had more infections episodes, deaths and a longer HS. Great variability between NI but had a common item; early intake. Although was seen patient’s recovery. Future studies with detailed NI characteristics are need. Nutritional status must be assessed for a higher acknowledgement of NI impact.


Palabras clave


Fast-track. Colorectal surgery. Perioperative care. Nutrition therapy.

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DOI: http://dx.doi.org/10.20960/nh.402

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