General Surgery Unit, S. Eugenio Hospital, Rome, Italy. Electronic address: https://twitter.com/MicheleGriecoMD.
Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Giovanni Pascale IRCCS, Naples, Italy.
Surg Oncol. 2022 Aug;43:101788. doi: 10.1016/j.suronc.2022.101788. Epub 2022 Jun 10.
Nutritional support is a keystone component in perioperative care in patients undergoing oncological surgery with a direct impact on surgical outcomes. This study aimed to evaluate how nutritional support in the surgical setting is managed and applied in Italian hospitals.
A national survey was designed by the Italian Society of Surgical Oncology (SICO) and disseminated in early 2021. The results were analyzed for the entire population and for comparing the following different subgroups: northern vs. southern regions; high-volume vs. low-volume centers; and junior vs. senior surgeons.
Out of the 141 responses collected from all Italian regions, 43.2% of the participants worked in a surgical unit where nutritional status evaluations and interventions were not routinely practiced, although the key features (nutritional counseling, oral supplementation, enteral and parenteral nutrition) were available in 77.3% of the hospitals. Among the participating centers, the ERAS protocol was systematically applied in only 29.5% of cases, and in 25.5% of cases, most of the items were followed, although not systematically. Among the surgeons who practiced in compliance with the ERAS pathways, almost half of the participants declared that the protocol was applied only for low-risk patients. No significant differences were documented when comparing Italian regions, high-volume vs. low-volume institutions or junior vs. senior participants.
Nutritional support in oncological surgery is frequently neglected in Italian hospitals, regardless of the geographic distribution and volumes of the institutions. A cultural change and an improvement in the availability of nutritional services are needed for widespread implementation.
营养支持是肿瘤外科患者围手术期护理的关键组成部分，直接影响手术结果。本研究旨在评估意大利医院如何管理和应用外科环境中的营养支持。
由意大利外科肿瘤学会（SICO）设计了一项全国性调查，并于 2021 年初进行了分发。对整个人群以及以下不同亚组进行了分析：北部与南部地区；高容量与低容量中心；以及初级与高级外科医生。
从意大利所有地区收集的 141 份回复中，43.2%的参与者在一个外科病房工作，在那里营养状况评估和干预措施没有常规进行，尽管 77.3%的医院都具备关键特征（营养咨询、口服补充、肠内和肠外营养）。在参与的中心中，只有 29.5%的病例系统地应用了 ERAS 方案，而在 25.5%的病例中，虽然不是系统地，但遵循了大部分项目。在遵守 ERAS 路径的外科医生中，近一半的参与者表示该方案仅适用于低风险患者。在比较意大利地区、高容量与低容量机构或初级与高级参与者时，没有记录到显著差异。
无论地理位置和机构的容量如何，营养支持在意大利医院中经常被忽视。需要进行文化变革和改善营养服务的可及性，以实现广泛实施。
