Baji Dheeraj Babu, Patel Jay P, Konanur Srinivasa Nithin Kumar, Gande Akshay, Anusha Madatala, Dar Hassaan
Research, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.
Research, Chirayu Medical College and Hospital, Bhopal, IND.
Cureus. 2022 Dec 29;14(12):e33094. doi: 10.7759/cureus.33094. eCollection 2022 Dec.
Malignancy is a catabolic state, which is precipitated with surgical intervention. Malnutrition is one of the main risk factors for poor outcomes of cancer surgery. We need to screen oncological patients for malnutrition using standardized screening tools, by which patients found to be at nutritional risk are then referred to a registered dietitian for further management. A detailed assessment is required in such patients, which helps in categorizing the patients based on the severity and rendering proper care. Preoperative nutrition care is often overlooked because of the urgency of operating on a cancer patient. Still, studies have shown preoperative nutritional building gives better surgical outcomes and good postoperative quality of life. Preoperative nutrition care includes both early and late preoperative care. For efficient preoperative nutrition care publishing, standard operating procedures at every healthcare center are recommended. Postoperative nutrition care is given to build the patient tackle the surgical trauma, and their diet mainly includes protein to minimize catabolism. Regardless of the route of nutrition delivery, providing appropriate nutrition care in the postoperative period improves cancer patients' condition drastically. Early postoperative nutrition is studied in different cancer surgeries and is considered ideal in cancer surgical patients. There is a need for consensus on the composition of postoperative nutrition. The diet of a cancer patient should include micronutrients like vitamins D and B and minerals along with the usual nutrition care. The use of special diets like branched-chain amino acids and immune nutrition is to be considered on a case-by-case basis and introducing them into the routine care of a patient needs to be studied extensively.
恶性肿瘤是一种分解代谢状态,手术干预会加剧这种状态。营养不良是癌症手术预后不良的主要风险因素之一。我们需要使用标准化筛查工具对肿瘤患者进行营养不良筛查,通过该工具发现有营养风险的患者随后会被转介给注册营养师进行进一步管理。对此类患者需要进行详细评估,这有助于根据严重程度对患者进行分类并提供适当护理。由于癌症患者手术的紧迫性,术前营养护理常常被忽视。然而,研究表明术前营养支持能带来更好的手术效果和良好的术后生活质量。术前营养护理包括早期和晚期术前护理。为了高效开展术前营养护理工作,建议每个医疗中心制定标准操作程序。术后营养护理旨在帮助患者应对手术创伤,其饮食主要包括蛋白质以尽量减少分解代谢。无论营养输送途径如何,在术后阶段提供适当的营养护理能显著改善癌症患者的状况。不同癌症手术都对术后早期营养进行了研究,术后早期营养被认为对癌症手术患者是理想的。术后营养的组成需要达成共识。癌症患者的饮食应包括维生素D和B等微量营养素、矿物质以及常规的营养护理。支链氨基酸和免疫营养等特殊饮食的使用应根据具体情况考虑,将其引入患者的常规护理需要进行广泛研究。