Health Questions and Answers

Question: How does nutritional repletion alter the response to surgery?


Several studies have demonstrated a marked reduction in complications and mortality of severely malnourished patients if given 7-10 days of preoperative nutrional support. These patients have improved serum proteins and immunocompetence. But still, the most common use of nutritional support is postoperative. Nutritional support should begin immediately postoperative if the patient is either severely malnourished or not expected to have oral intake for 5-7 days. A number of studies support this. The question of whether to use TPN or total enteral nutrition (TEN) has yet to be answered conclusively. Enteral nutrition is better on general principles, but most of the abdominal cancer operations interfere with the patient’s tolerance for enteral nutrition. Early nutritional support can be carried out through surgical jejunostomy but this has not yet become common practice in surgical oncology.

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