Effect of an Evidence-Based Nutrition Care Pathway for Cancer Patients Undergoing Gastrointestinal and Pelvic Surgery

Illuminating the nutrition-related policy-practice gaps in colorectal cancer survivorship

PURPOSE

Colorectal cancer (CRC) is among the three most commonly diagnosed cancers globally, after breast and lung cancer, with an estimated 2 million new cases each year, comprising ten per cent of all cancers worldwide. CRC has a complex aetiology associated with several nutrition-related risk factors. Cancer survivors frequently report alterations to their dietary habits and nutritional intake, with related adverse impacts on health-related quality of life (QOL). Whilst nutrition-related factors are recognised as survivor priorities and embedded in survivor care policies, dietary support is frequently not the standard of care in practice.

METHODS AND RESULTS

In this Commentary, we present details of a critical policy-practice gap for CRC survivors across the spectrum of nutrition care that we have seen growing in the literature, in hospitals, community and private practice.

CONCLUSION

As these nutrition concerns can adversely impact QOL and morbidity and mortality risks, we hope to raise awareness of these issues to provide a basis of future work in this area, so that policymakers and clinicians can improve support and outcomes for CRC survivors and their families.

Nutritional Intervention Facilitates Food Intake after Epilepsy Surgery

Background: We investigated whether nutritional intervention affected food intake after epilepsy surgery and if intravenous infusions were required in patients with epilepsy. We hypothesized that postoperative food intake would be increased by nutritional intervention. The purpose of this study was to compare postoperative food intake in the periods before and after nutritional intervention. Methods: Between September 2015 and October 2020, 124 epilepsy surgeries were performed. Of these, 65 patients who underwent subdural electrode placement followed by open cranial epilepsy surgery were studied. Postoperative total food intake, rate of maintenance of food intake, and total intravenous infusion were compared in the periods before and after nutritional intervention. Results: A total of 26 females and 39 males (age range 3–60, mean 27.1, standard deviation (SD) 14.3, median 26 years) were enrolled. Of these, 18 females and 23 males (3–60, mean 28.2, SD 15.1, median 26 years) were in the pre-nutritional intervention period group, and eight females and 16 males (5–51, mean 25.2, SD 12.9, median 26.5 years) were in the post-nutritional intervention period group. The post-nutritional intervention period group showed significantly higher food intake (p = 0.015) and lower total infusion (p = 0.006) than the pre-nutritional intervention period group. Conclusion: The nutritional intervention increased food intake and also reduced the total amount of intravenous infusion. To identify the cut-off day to cease the intervention and to evaluate whether the intervention can reduce the complication rate, a multicenter study with a large number of patients is warranted.