Enteral nutrition reduced postoperative complications but increased minor adverse effects in gastrointestinal cancer
QUESTION: In malnourished patients having elective surgery for gastrointestinal cancer, does enteral nutrition reduce postoperative complications when compared with parenteral nutrition?
Design
Randomised {allocation concealed}*, unblinded, controlled trial with follow up to discharge.
Setting
10 centres in Italy.
Patients
317 patients who were ≥18 years of age (mean age 64 y, 58% men) and had weight loss ≥10% of usual body weight in the previous 6 months, histologically confirmed gastrointestinal cancer, and major planned elective surgery. Exclusion criteria were hepatic, renal, or cardiac dysfunction; Karnofsky performance status <60; pregnancy; ongoing infection; or intestinal anastomosis of the large bowel without a diverting stoma. Follow up was complete.
Intervention
Patients were allocated to enteral (n=159) or parenteral (n=158) nutrition. Patients in the enteral nutrition group had a jejunostomy feeding catheter or nasojejunal feeding tube placed during surgery. …
