Ortiz RS, Aguilar MF, Llanes DG, González DME, González VJA, Santana PS, Barreto PJ

Language: Spanish
References: 20
Page: 114-121
PDF size: 75.74 Kb.

ABSTRACT

The nutritional status of a patient with a malignant colorectal disease (MCD) can affect not only the results of the surgical intervention, but also the extent of the surgical procedure to be carried upon the patient. A working hypothesis was advanced that some patients with MCD in which a potentially curable surgery (resection of the tumor, followed -or not- by restitution of the bowel continuity) would be the treatment of choice, might be derived instead to palliative procedures because of existing nutritional derangement. To prove this hypothesis, 79 patients were recruited among those admitted to the “Hermanos Ameijeiras” Hospital and operated upon after being diagnosed with a MCD, between December 2002 and June 2004. The following indicators were obtained from each patient during the preoperatory workup: Height, current weight, serum albumin. The body mass index (BMI) was calculated in each instance. The subjective global assessment form [Detsky AS, McLaughlin JR, Baker JP et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr 1987:11:8-13] was administered to each of the patients following admission, according to the procedure drafted by the local Nutritional Support Group, and conducted by one of the members of the Group. The acting surgeons were unaware of the SGA results. The nutritional status of the patient was independently established after a BMI value ‹ 18.5 kg/m² and/or a serum albumin value ‹ 35 g/L. Associations between: (1) SGA score and the nutritional status of the patient, (2) SGA score and the surgical conduct adopted (Potentially curable/Palliative), (3) SGA score and the occurrence of post-surgical complications, and (4) SGA score and the occurrence of post-surgical deaths, were assessed. Upon concluding this study the following results were obtained: (1) SGA score was not associated with the nutritional status of the patient; (2) Surgical conduct was associated with SGA score: potentially curable surgeries were more frequent among patients scoring A after SGA administration (64.2%). In contrast, palliative procedures were prevalent among patients with SGA scores B or C (66.7%) (p ‹ 0.05); (3) SGA score was not associated with the occurrence of post-surgical complications; (4) SGA score was not associated with the occurrence of post-surgical deaths. Nutritional derangement could act as a factor conditioning what surgical conduct to perform in a patient with MCD.

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