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Effect of Early Peripheral Parenteral Nutrition Support in an Enhanced Recovery Program for Colorectal Cancer Surgery: A Randomized Open Trial

Background: Peripheral parenteral nutrition allows repletion of acute nutrient deficiencies and could prevent further nutrition deficits before and after colorectal surgery. A randomized open study was performed to evaluate the effect of perioperative peripheral parenteral nutrition (PPN) support on...

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Autores principales: Sánchez-Guillén, Luis, Soriano-Irigaray, Leticia, López-Rodríguez-Arias, Francisco, Barber, Xavier, Murcia, Ana, Alcaide, M José, Aranaz-Ostáriz, Verónica, Soler-Silva, Álvaro, Navarro-Ruiz, Andrés, Arroyo, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396922/
https://www.ncbi.nlm.nih.gov/pubmed/34441942
http://dx.doi.org/10.3390/jcm10163647
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author Sánchez-Guillén, Luis
Soriano-Irigaray, Leticia
López-Rodríguez-Arias, Francisco
Barber, Xavier
Murcia, Ana
Alcaide, M José
Aranaz-Ostáriz, Verónica
Soler-Silva, Álvaro
Navarro-Ruiz, Andrés
Arroyo, Antonio
author_facet Sánchez-Guillén, Luis
Soriano-Irigaray, Leticia
López-Rodríguez-Arias, Francisco
Barber, Xavier
Murcia, Ana
Alcaide, M José
Aranaz-Ostáriz, Verónica
Soler-Silva, Álvaro
Navarro-Ruiz, Andrés
Arroyo, Antonio
author_sort Sánchez-Guillén, Luis
collection PubMed
description Background: Peripheral parenteral nutrition allows repletion of acute nutrient deficiencies and could prevent further nutrition deficits before and after colorectal surgery. A randomized open study was performed to evaluate the effect of perioperative peripheral parenteral nutrition (PPN) support on postoperative morbidity after colorectal cancer surgery within an enhanced recovery program. Methods: Patients were randomized into two groups: peripheral parenteral nutrition (PPN) (with Peri-Olimel N4-E) versus conventional fluid therapy (FT). Ninety-day postoperative complications, laboratory parameters, length of hospital stay, and compliance with the ERAS protocol were assessed. Results: A total of 158 patients were analysed. The overall 90-day complication rate was 38.6% (61 patients), and 24 patients had major complications (Clavien–Dindo III–V) (15.2%). In the multivariate analysis, the intervention (PPN vs. FC) showed a protective effect against postoperative complications (p = 0.0031, OR = 0.2 (CI: 0.08–0.87)). Following ordinal regression, PPN and early oral tolerance showed a protective effect, being less likely to develop complications or to move from minor to major complications. In patients with low compliance to ERAS during the first postoperative day, PPN showed a protective effect, preventing 28% of morbidity. Conclusions: Perioperative peripheral parenteral nutrition (PPN) support with Peri-Olimel N4-E in colorectal cancer surgery associated with early oral intake could reduce postoperative complications.
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spelling pubmed-83969222021-08-28 Effect of Early Peripheral Parenteral Nutrition Support in an Enhanced Recovery Program for Colorectal Cancer Surgery: A Randomized Open Trial Sánchez-Guillén, Luis Soriano-Irigaray, Leticia López-Rodríguez-Arias, Francisco Barber, Xavier Murcia, Ana Alcaide, M José Aranaz-Ostáriz, Verónica Soler-Silva, Álvaro Navarro-Ruiz, Andrés Arroyo, Antonio J Clin Med Article Background: Peripheral parenteral nutrition allows repletion of acute nutrient deficiencies and could prevent further nutrition deficits before and after colorectal surgery. A randomized open study was performed to evaluate the effect of perioperative peripheral parenteral nutrition (PPN) support on postoperative morbidity after colorectal cancer surgery within an enhanced recovery program. Methods: Patients were randomized into two groups: peripheral parenteral nutrition (PPN) (with Peri-Olimel N4-E) versus conventional fluid therapy (FT). Ninety-day postoperative complications, laboratory parameters, length of hospital stay, and compliance with the ERAS protocol were assessed. Results: A total of 158 patients were analysed. The overall 90-day complication rate was 38.6% (61 patients), and 24 patients had major complications (Clavien–Dindo III–V) (15.2%). In the multivariate analysis, the intervention (PPN vs. FC) showed a protective effect against postoperative complications (p = 0.0031, OR = 0.2 (CI: 0.08–0.87)). Following ordinal regression, PPN and early oral tolerance showed a protective effect, being less likely to develop complications or to move from minor to major complications. In patients with low compliance to ERAS during the first postoperative day, PPN showed a protective effect, preventing 28% of morbidity. Conclusions: Perioperative peripheral parenteral nutrition (PPN) support with Peri-Olimel N4-E in colorectal cancer surgery associated with early oral intake could reduce postoperative complications. MDPI 2021-08-18 /pmc/articles/PMC8396922/ /pubmed/34441942 http://dx.doi.org/10.3390/jcm10163647 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sánchez-Guillén, Luis
Soriano-Irigaray, Leticia
López-Rodríguez-Arias, Francisco
Barber, Xavier
Murcia, Ana
Alcaide, M José
Aranaz-Ostáriz, Verónica
Soler-Silva, Álvaro
Navarro-Ruiz, Andrés
Arroyo, Antonio
Effect of Early Peripheral Parenteral Nutrition Support in an Enhanced Recovery Program for Colorectal Cancer Surgery: A Randomized Open Trial
title Effect of Early Peripheral Parenteral Nutrition Support in an Enhanced Recovery Program for Colorectal Cancer Surgery: A Randomized Open Trial
title_full Effect of Early Peripheral Parenteral Nutrition Support in an Enhanced Recovery Program for Colorectal Cancer Surgery: A Randomized Open Trial
title_fullStr Effect of Early Peripheral Parenteral Nutrition Support in an Enhanced Recovery Program for Colorectal Cancer Surgery: A Randomized Open Trial
title_full_unstemmed Effect of Early Peripheral Parenteral Nutrition Support in an Enhanced Recovery Program for Colorectal Cancer Surgery: A Randomized Open Trial
title_short Effect of Early Peripheral Parenteral Nutrition Support in an Enhanced Recovery Program for Colorectal Cancer Surgery: A Randomized Open Trial
title_sort effect of early peripheral parenteral nutrition support in an enhanced recovery program for colorectal cancer surgery: a randomized open trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396922/
https://www.ncbi.nlm.nih.gov/pubmed/34441942
http://dx.doi.org/10.3390/jcm10163647
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