Modern Approaches to Perioperative Nutritional Support in Oncology

A.E. Shestopalov

GBOU DPO «Russian Medical Academy of Postgraduate Education» The Ministry of Health of the Russian Federation, Moscow

For citation: Shestopalov AE. Modern Approaches to Perioperative Nutritional Support in Oncology. Intensive Care Herald. 2016;2:5–14.


Malnutrition in patients with cancer is the result of gross metabolic disorders, cachexia and anorexia associated with tumor necrosis factor. Metabolic disorders include disorders ofcarbohydrate, protein, lipid metabolism and enzymatic components that increase energy requirements and deficiency of essential nutrients. In addition, considerable importance in the formation of a nutrient deficiency is the local influence of the tumor — destructive processes, compression or destruction of surrounding tissue and organs. The special features of metabolic disorders and malnutrition in cancer patients should include immunosuppression, which is a negative prognostic factor for the outcome ofsurgical treatment.

Along with preoperative nutritional deficiency metabolic response to surgical trauma has significant effect on the postoperative course and results of surgical treatment. Catabolic type metabolism in combination with morphological and functional lesions of the gastrointestinal tract (intestinal distress syndrome) is characterized by the development of protein-energy malnutrition (PEM), nutritional status violation and impossibility of providing the body with nutrients naturally. In turn, malnutrition and active proteolysis contribute to slowing down regenerative processes, wound healing, cell differentiation and disorders of the immune system increasing the risk of infectious complications.

The current situation in recent years, the concept of nutritional support in surgical patients is intended to sinclude enteral and parenteral nutrition (glutamine, arginine, omega-3 fatty acids).

Keywords: nutritional support, cancer patients, protein-energy malnutrition

Received: 16.06.2016


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