361. THE IMPACT OF A PROGRAM TO IMPROVE PREOPERATIVE NUTRITION AND REHABILITATION FOR ESOPHAGEAL CANCER PATIENTS

Abstract

Abstract Background Improvement of the preoperative inflammation, nutrition, and other systemic conditions may reduce surgical complications and improve the prognosis of cancer. The usefulness of preoperative nutritional therapy and rehabilitation has recently been discussed. We created a novel program of preoperative rehabilitation and nutritional support to improve postoperative outcomes. We examined the nutritional status and blood electrolyte predisposition before and after this program. Methods Thirty five patients who underwent esophagectomy for esophageal cancer. These patients performed muscle strengthening exercise and received jelly beverage containing branched-chain amino acids immediately after rehabilitation and immune-modulating liquid diets for 7 consecutive days before surgery. Nutritional guidance was provided by a dietitian, who set a daily energy target of 30 kcal/kg and a protein target of 1.2 g/kg. Upper and lower limb strength training was performed with a physical therapist. Blood biochemical data on nutrition such as serum Alb, PreAlb, CRP, levels were compared after preoperative support. Results Thirty five patients who underwent esophagectomy for esophageal cancer in this period and evaluate their blood and serum samples. The average age of the patients was 66 years, 29 men and 6 women. Serum Alb level was 4.01 ± 0.4 g/dl before admission and 3.74 ± 0.35 g/dl the day before surgery (p = 0.04), and serum transthyretin level was unchanged from 28.9 ± 5.5 mg/dl to 26.1 ± 4.75 mg/dl. Serum CRP level tended to decrease from O.23 ± 0.528 mg/dl before admission to 0.14 ± 0.23 mg/dl the day before surgery. Other index of nutritional status did not change significantly before or after the program. Improvements in preoperative inflammation and nutrition are expected to decrease surgical complications and contribute to cancer prognosis. Our study and intervention in the present study may have decreased inflammation, although it was not a clear objective improvement in nutritional status. The short duration of the intervention may have prevented a significant difference. A less prolonged hospitalization is not realistic and the most effective nutritional rehabilitation intervention should be devised in the future.