Effects of preoperative nutritional risk screening combined with enhanced recovery after surgery concept on postoperative functional recovery and nutritional status in gastric cancer patients
10.3969/j.issn.1009-0754.2025.07.015
- VernacularTitle:术前营养风险筛查联合快速康复理念对胃癌患者术后功能恢复及营养状况的影响
- Author:
Dan CAO
1
;
Jing LU
;
Na LIU
Author Information
1. 223300 江苏 淮安,南京医科大学附属淮安第一医院胃肠外科
- Keywords:
Gastric cancer;
Enhanced recovery after surgery;
Nutritional risk screening;
Functional recovery;
Nutritional status
- From:
Journal of Navy Medicine
2025;46(7):721-727
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of nutritional risk screening based on the enhanced recovery after surgery(ERAS)concept on postoperative functional recovery and nutritional status in gastric cancer patients.Methods A total of 98 gastric cancer patients who underwent surgery at The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University between March 2020 and March 2023 were selected as research objects.They were assigned to control group or observation group by a random number table,with 49 patients in each group.Conventional postoperative rehabilitation and nutritional support were given to both groups.The observation group additionally received preoperative nutritional risk screening and ERAS-based nursing.Postoperative recovery indicators(gastrointestinal peristalsis time,evacuation time,defecation time,and bowel sound recovery time),gastrointestinal hormones(serum motilin,gastrin,and somatostatin),and gut microbiota distribution(Bifidobacterium,Enterococcus,Lactobacillus,and Escherichia coli)were compared between the two groups.Nutritional indicators(albumin,hemoglobin,transferrin,and total protein)were also compared before intervention,4 and 8 weeks after intervention.The overall nutritional status was assessed by the Nutritional Risk Screening 2002(NRS 2002),Patient-Generated Subjective Global Assessment(PG-SGA),dietary symptom scale,and dietary compliance scale.The incidence of gastrointestinal complications was compared.Results One day before surger,there were no significant differences in nutritional indicators,gastrointestinal hormones,or microbiota distribution between the two groups(P>0.05).The gastrointestinal peristalsis time,evacuation time,defecation time,and bowel sound recovery time in the observation group were significantly shorter than those in the control group after intervention(P<0.05).Serum motilin,gastrin,and somatostatin levels on day 7 after surgery were lower than preoperative levels in both groups,but the levels of gastrointestinal hormones in the observation group were higher than those in the control group(P<0.05).The observation group had more Bifidobacterium and Lactobacillus and less Enterococcus and Escherichia coli than the control group at 7 days postoperatively(P<0.05).The albumin,hemoglobin,transferrin,and total protein levels in the observation group were significantly higher than those in the control group at 4 and 8 weeks postoperatively(P<0.05).The observation group scored lowly in the NRS 2002,PG-SGA,and dietary symptom scale,and scored highly in the dietary compliance scale as compared with control group(P<0.05).The incidence of complications in the observation group was 12.24%(6/49),which was significantly lower than that in the control group(30.61%[15/49],P<0.05).Conclusion Preoperative nutritional risk screening combined with ERAS concept can effectively enhance postoperative functional recovery,improve gastrointestinal hormone levels,adjust gut microbiota distribution,optimize nutritional status,and reduce the incidence of gastrointestinal complications in gastric cancer patients.It is worthy of promotion and application in clinical practice.
