Perioperative total parenteral nutrition in patients with gastrointestinal cancer

Abstract

Forty-one male surgical patients with gastrointestinal cancer were randomized into three groups on the basis of preoperative weight loss: Group I (20 patients)—mean age 64.1 ± 11.0 years, less than 10-lb weight loss, no TPN; Group II (9 patients)—mean age 65.8 ± 12.0 greater than 10 pound weight loss, no TPN; Group III (12 patients)—mean age 63.7 ± 10.7 years, greater than 10-lb weight loss, TPN. Group III received greater than 2000 cc of D25/4.25% Travasol for at least 5 days preoperatively and 8 days postoperatively. Major postoperative complications included abscess, anastomotic leak, or wound infection. Results: Preoperative immunocompetence was no different between any group ( P > 0.05). Postoperative weight loss was significantly greater in Group I than in Group III ( P < 0.01) and Group II than in Group III ( P < 0.01). Postoperative changes in serum albumin were not significant between any of the groups ( P > 0.05). Rate of major complications was not significantly different between any of the groups ( P > 0.05). Mortality was 10% in Group I, 0% in Group II, and 0% in Group III. Conclusion: An 18-day duration of perioperative TPN in comparable randomized patients based on preoperative weight loss does not alter the rate of major postoperative complications or mortality, but allows patients to maintain weight.