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评估胃肠道癌症术前康复计划中的营养成分:术前康复是否名副其实?

Evaluation of nutrition components within prehabilitation programs in gastrointestinal cancers: Is prehab worth the hype?

机构信息

UCLA David Geffen School of Medicine, Los Angeles, California, USA.

Stanford Health Care, Comprehensive Cancer Center, Stanford, California, USA.

出版信息

Nutr Clin Pract. 2024 Feb;39(1):117-128. doi: 10.1002/ncp.11079. Epub 2023 Sep 29.

Abstract

Nutrition impact symptoms and unintended weight loss are prevalent in patients with gastrointestinal cancers, especially during the perioperative period or while prescribed anticancer treatments. Because patients may experience loss of lean body mass and malnutrition, aggressive nutrition intervention prior to surgery should be considered. Cancer prehabilitation is a process spanning the care continuum from diagnosis to the time of surgery encompassing nutrition support, psychological and physical assessment, and targeted interventions. Thirteen studies published between 2013 and 2023 were included in this review and evaluated prehabilitation programs' impact on postoperative outcomes in patients with gastrointestinal cancers. Literature continues to emerge supporting the integration of nutrition into a prehabilitation program because of its potential to contribute to improved clinical outcomes, quality of life, and cost-effectiveness, but considerable variation exists with respect to the specific recommendations provided by current prehabilitation programs.

摘要

营养相关不良症状和非计划性体重减轻在胃肠道癌症患者中较为常见,尤其是在围手术期或接受抗癌治疗期间。由于患者可能会出现去脂体重丢失和营养不良,因此应考虑在术前进行积极的营养干预。癌症康复是一个跨越从诊断到手术时间的连续护理过程,包括营养支持、心理和身体评估以及有针对性的干预。本综述纳入了 2013 年至 2023 年间发表的 13 项研究,评估了胃肠道癌症患者的康复计划对术后结局的影响。由于营养支持有可能改善临床结局、生活质量和成本效益,因此将营养纳入康复计划的相关研究不断涌现,但目前的康复计划在具体建议方面存在很大差异。

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