Mide Kanserli Hastalarda Preoperatif Nütrisyonel Desteğin Postoperatif Morbidite ve Mortalite Üzerine Etkisi: Tek Merkezli Retrospektif Veri Analizi

Öz

Amaç: Mide kanserli hastalarda kilo kaybı ve malnütrisyon sıklıkla görülmektedir. Bu nedenle özellikle mide kanserli hastalarda beslenme önemlidir. Bu çalışmada mide kanserli hastalarda ameliyat öncesi beslenme desteğinin ameliyat sonrası morbidite ve mortalite üzerine etkisini belirlemeyi amaçladık.
Materyal ve Metot: Aralık 2015 ile Aralık 2019 tarihleri arasında mide kanseri nedeniyle gastrektomi yapılan toplam 110 hasta retrospektif olarak incelendi. Hastalara ameliyat öncesi ve sonrası beslenme desteği verilip verilmediği belirlendi. Klinikopatolojik özellikler ve kısa dönem sonuçları karşılaştırıldı.
Bulgular: Gastrektomi yapılan hastalarda genel morbidite %29.1 (n=32) idi. Yaş arttıkça majör komplikasyon oranının istatistiksel olarak arttığı görüldü (p<0.001). Komorbidite de majör komplikasyonlar için bir risk faktörü olarak bulundu (OR 3.917, %95 CI 1.423-10.781; p=0.006). Özellikle diyabet tanısı olan hastalarda komplikasyon insidansı artmaktadır (OR 3.743, %95 CI 1.201-11.666; p=0.040). Preoperatif beslenme alan hastaların %6.7’sinde (n=2) anastomoz kaçağı gelişirken, beslenme desteği almayan hastaların %10’unda (n=8) anastomoz kaçağı gelişti (p=0.588). Aynı şekilde preoperatif nütrisyon desteği alan hastaların postoperatif yatış süresi, postoperatif komplikasyonlar ve mortalitesi arasındaki ilişki kanıtlanamamıştır.
Sonuç: Bu çalışma, mide kanserli hastalarda ameliyat öncesi beslenmenin morbidite ve mortalite oranlarında iyileşme ile ilişkili olmadığını ortaya koymaktadır. Mide kanserli hastalarda ameliyat öncesi beslenme ile morbidite-mortalite oranları arasındaki kesin ilişkiyi ortaya çıkarmak için ameliyat öncesi beslenme desteğine odaklanan geniş, çok merkezli ileriye dönük çalışmalara ihtiyaç vardır.

The Effect of Preoperative Nutritional Support on Postoperative Morbidity and Mortality in Patients With Gastric Cancer: A Single Center Retrospective Study

Abstract

Aim: Weight loss and malnutrition are frequently observed in patients with gastric cancer. Therefore, nutrition is important, especially in patients with gastric cancer. In this study, we aimed to identify the effect of preoperative nutritional support on postoperative morbidity and mortality in patients with gastric cancer.
Material and Method: A total of 110 patients underwent gastrectomy due to gastric cancer between December 2015 and December 2019 were retrospectively analyzed. It was determined whether the patients were given preoperative and postoperative nutritional support. Clinicopathological features and short-term results were compared.
Results: Overall morbidity was 29.1% (n=32) in patients who underwent gastrectomy. It was observed that the rate of major complications increased statistically with increasing age (p<0.001). Comorbidity was also found to be a risk factor for major complications (OR 3.917, 95% CI 1.423-10.781; p=0.006). The incidence of complications increases especially in patients with a diagnosis of diabetes (OR 3.743, 95% CI 1.201-11.666; p=0.040). While anastomotic leak developed in 6.7% (n=2) of the patients who were taken preoperative nutrition, anastomotic leak developed in 10% (n=8) of the patients who were not taken nutritional support (p=0.588). Likewise, the relationship between the postoperative length of stay, postoperative complications and mortality of patients receiving preoperative nutritional support could not been proven.
Conclusion: The present study reveals that preoperative nutrition in patients with gastric cancer was not associated with improved morbidity and mortality rates. Large, multicenter prospective studies focusing on preoperative nutritional support are needed to uncover the exact relation of preoperative nutrition and morbidity-mortality rates in patients with gastric cancer.

Keywords

• gastrectomy
• nutritional support
• gastric cancer

Kaynakça

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