Cai Bin, Luo Lan, Zhu Chenping, Meng Liping, Shen Qing, Fu Yafei, Wang Mingjie, Chen Sue
Department of Quality Management, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Clinical Nutrition, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
Front Oncol. 2023 Sep 5;13:1132972. doi: 10.3389/fonc.2023.1132972. eCollection 2023.
Malnutrition is common in patients undergoing surgery for cancers and is a risk factor for postoperative outcomes. Body composition provides information for precise nutrition intervention in perioperative period for improving patients' postoperative outcomes.
The aim was to determine changes in parameters of body composition and nutritional status of cancer patients during perioperative period.
A total of 92 patients diagnosed with cancer were divided into gastrointestinal and non-gastrointestinal cancer group according to different cancer types. The patients body composition assessed by bioelectrical impedance vector analysis (BIVA) on the day before surgery, postoperative day 1 and 1 day before discharge. The changes between two groups were compared and the correlation between body composition and preoperative serum nutritional indexes was analyzed.
The nutritional status of all patients become worse after surgery, and phase angle (PA) continued to decrease in the perioperative period. Fat-free mass (FFM), fat-free mass index (FFMI), skeletal muscle mass (SMM), extracellular water (ECW), total body water (TBW), hydration, and body cell mass (BCM) rise slightly and then fall in the postoperative period in patients with gastrointestinal cancer, and had a sustained increase in non-gastrointestinal patients, respectively (<0.05). Postoperative body composition changes in patients with gastrointestinal cancer are related to preoperative albumin, pre-albumin, hemoglobin, and C-reactive protein (<0.05), whereas postoperative body composition changes in patients with non-gastrointestinal cancer are related to age (<0.05).
Significant changes in body composition both in patients with gastrointestinal cancer and non-gastrointestinal cancer during perioperative period are observed. Changes in body composition for the cancer patients who undergoing surgery are related to age and preoperative serum nutrition index.
营养不良在癌症手术患者中很常见，是术后预后的一个风险因素。身体成分可为围手术期精确的营养干预提供信息，以改善患者的术后预后。
确定癌症患者围手术期身体成分参数和营养状况的变化。
92例确诊为癌症的患者根据癌症类型分为胃肠道癌组和非胃肠道癌组。在手术前一天、术后第1天和出院前1天通过生物电阻抗矢量分析（BIVA）评估患者的身体成分。比较两组之间的变化，并分析身体成分与术前血清营养指标之间的相关性。
所有患者术后营养状况均变差，围手术期相角（PA）持续下降。胃肠道癌患者术后无脂肪量（FFM）、无脂肪量指数（FFMI）、骨骼肌量（SMM）、细胞外液（ECW）、总体水（TBW）、水合作用和身体细胞量（BCM）先略有上升然后下降，而非胃肠道癌患者则持续增加（P<0.05）。胃肠道癌患者术后身体成分变化与术前白蛋白、前白蛋白、血红蛋白和C反应蛋白有关（P<0.05），而非胃肠道癌患者术后身体成分变化与年龄有关（P<0.05）。
观察到胃肠道癌和非胃肠道癌患者围手术期身体成分均有显著变化。接受手术的癌症患者身体成分的变化与年龄和术前血清营养指标有关。
