Feeding tube placement during cytoreductive surgery and heated intraperitoneal chemotherapy does not improve postoperative nutrition and is associated with longer length of stay and higher readmission rates

Sean P. Dineen, Kristen A. Robinson, Christina L. Roland, Karen A. Beaty, Safia Rafeeq, Paul F. Mansfield, Richard E. Royal, Keith F. Fournier

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Patients with colorectal cancer and peritoneal carcinomatosis (CRC/PC) may benefit from cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC). Nutritional support is frequently required for patients after CRS/HIPEC. It remains unclear if placement of feeding access is of benefit in regard to improving postoperative nutrition in this patient population. Materials and methods: Patients with CRC/PC who underwent complete cytoreduction were evaluated. Preoperative and postoperative nutritional data and discharge outcomes were retrospectively recorded. The presence of a feeding tube and PCI scores were recorded by review of operative notes. Readmission rates were calculated for patients at 30 d and 60 d after discharge from hospital. Results: Forty-one patients underwent CRS/HIPEC, 25 had feeding tube placement at the time of surgery. Weight loss was common after HIPEC as 38 of 41 patients demonstrated weight loss. The mean weight loss was 7.6%. total parenteral nutrition was required at discharge in four patients (7.9%); three of these patients had feeding access placed. There was no difference in the degree of weight loss between groups (7.1±3.7% no tube versus 7.9±5.8% patients with tube; P=0.608). The mean decrease in albumin was 12.7% but was not significantly different in patients with feeding access and those without (10.0% versus 14.75%; P=0.773). Sixty-day readmission rates were higher in patients with feeding tubes (36% compared with 0%, P<0.01). Conclusions: Significant nutritional loss is common after CRS/HIPEC for patients with CRC/PC. Feeding tube placement does not prevent this and appears to be related to higher readmission rates and longer length of stay.

Original languageEnglish (US)
JournalJournal of Surgical Research
DOIs
StateAccepted/In press - May 27 2015

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Enteral Nutrition
Length of Stay
Drug Therapy
Weight Loss
Colorectal Neoplasms
Carcinoma
Nutritional Support
Total Parenteral Nutrition
Albumins

Keywords

  • Carcinomatosis
  • Cytoreduction
  • Feeding tube
  • HIPEC
  • Nutrition

ASJC Scopus subject areas

  • Surgery

Cite this

Feeding tube placement during cytoreductive surgery and heated intraperitoneal chemotherapy does not improve postoperative nutrition and is associated with longer length of stay and higher readmission rates. / Dineen, Sean P.; Robinson, Kristen A.; Roland, Christina L.; Beaty, Karen A.; Rafeeq, Safia; Mansfield, Paul F.; Royal, Richard E.; Fournier, Keith F.

In: Journal of Surgical Research, 27.05.2015.

Research output: Contribution to journalArticle

Dineen, Sean P. ; Robinson, Kristen A. ; Roland, Christina L. ; Beaty, Karen A. ; Rafeeq, Safia ; Mansfield, Paul F. ; Royal, Richard E. ; Fournier, Keith F. / Feeding tube placement during cytoreductive surgery and heated intraperitoneal chemotherapy does not improve postoperative nutrition and is associated with longer length of stay and higher readmission rates. In: Journal of Surgical Research. 2015.
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title = "Feeding tube placement during cytoreductive surgery and heated intraperitoneal chemotherapy does not improve postoperative nutrition and is associated with longer length of stay and higher readmission rates",
abstract = "Background: Patients with colorectal cancer and peritoneal carcinomatosis (CRC/PC) may benefit from cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC). Nutritional support is frequently required for patients after CRS/HIPEC. It remains unclear if placement of feeding access is of benefit in regard to improving postoperative nutrition in this patient population. Materials and methods: Patients with CRC/PC who underwent complete cytoreduction were evaluated. Preoperative and postoperative nutritional data and discharge outcomes were retrospectively recorded. The presence of a feeding tube and PCI scores were recorded by review of operative notes. Readmission rates were calculated for patients at 30 d and 60 d after discharge from hospital. Results: Forty-one patients underwent CRS/HIPEC, 25 had feeding tube placement at the time of surgery. Weight loss was common after HIPEC as 38 of 41 patients demonstrated weight loss. The mean weight loss was 7.6{\%}. total parenteral nutrition was required at discharge in four patients (7.9{\%}); three of these patients had feeding access placed. There was no difference in the degree of weight loss between groups (7.1±3.7{\%} no tube versus 7.9±5.8{\%} patients with tube; P=0.608). The mean decrease in albumin was 12.7{\%} but was not significantly different in patients with feeding access and those without (10.0{\%} versus 14.75{\%}; P=0.773). Sixty-day readmission rates were higher in patients with feeding tubes (36{\%} compared with 0{\%}, P<0.01). Conclusions: Significant nutritional loss is common after CRS/HIPEC for patients with CRC/PC. Feeding tube placement does not prevent this and appears to be related to higher readmission rates and longer length of stay.",
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T1 - Feeding tube placement during cytoreductive surgery and heated intraperitoneal chemotherapy does not improve postoperative nutrition and is associated with longer length of stay and higher readmission rates

AU - Dineen, Sean P.

AU - Robinson, Kristen A.

AU - Roland, Christina L.

AU - Beaty, Karen A.

AU - Rafeeq, Safia

AU - Mansfield, Paul F.

AU - Royal, Richard E.

AU - Fournier, Keith F.

PY - 2015/5/27

Y1 - 2015/5/27

N2 - Background: Patients with colorectal cancer and peritoneal carcinomatosis (CRC/PC) may benefit from cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC). Nutritional support is frequently required for patients after CRS/HIPEC. It remains unclear if placement of feeding access is of benefit in regard to improving postoperative nutrition in this patient population. Materials and methods: Patients with CRC/PC who underwent complete cytoreduction were evaluated. Preoperative and postoperative nutritional data and discharge outcomes were retrospectively recorded. The presence of a feeding tube and PCI scores were recorded by review of operative notes. Readmission rates were calculated for patients at 30 d and 60 d after discharge from hospital. Results: Forty-one patients underwent CRS/HIPEC, 25 had feeding tube placement at the time of surgery. Weight loss was common after HIPEC as 38 of 41 patients demonstrated weight loss. The mean weight loss was 7.6%. total parenteral nutrition was required at discharge in four patients (7.9%); three of these patients had feeding access placed. There was no difference in the degree of weight loss between groups (7.1±3.7% no tube versus 7.9±5.8% patients with tube; P=0.608). The mean decrease in albumin was 12.7% but was not significantly different in patients with feeding access and those without (10.0% versus 14.75%; P=0.773). Sixty-day readmission rates were higher in patients with feeding tubes (36% compared with 0%, P<0.01). Conclusions: Significant nutritional loss is common after CRS/HIPEC for patients with CRC/PC. Feeding tube placement does not prevent this and appears to be related to higher readmission rates and longer length of stay.

AB - Background: Patients with colorectal cancer and peritoneal carcinomatosis (CRC/PC) may benefit from cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC). Nutritional support is frequently required for patients after CRS/HIPEC. It remains unclear if placement of feeding access is of benefit in regard to improving postoperative nutrition in this patient population. Materials and methods: Patients with CRC/PC who underwent complete cytoreduction were evaluated. Preoperative and postoperative nutritional data and discharge outcomes were retrospectively recorded. The presence of a feeding tube and PCI scores were recorded by review of operative notes. Readmission rates were calculated for patients at 30 d and 60 d after discharge from hospital. Results: Forty-one patients underwent CRS/HIPEC, 25 had feeding tube placement at the time of surgery. Weight loss was common after HIPEC as 38 of 41 patients demonstrated weight loss. The mean weight loss was 7.6%. total parenteral nutrition was required at discharge in four patients (7.9%); three of these patients had feeding access placed. There was no difference in the degree of weight loss between groups (7.1±3.7% no tube versus 7.9±5.8% patients with tube; P=0.608). The mean decrease in albumin was 12.7% but was not significantly different in patients with feeding access and those without (10.0% versus 14.75%; P=0.773). Sixty-day readmission rates were higher in patients with feeding tubes (36% compared with 0%, P<0.01). Conclusions: Significant nutritional loss is common after CRS/HIPEC for patients with CRC/PC. Feeding tube placement does not prevent this and appears to be related to higher readmission rates and longer length of stay.

KW - Carcinomatosis

KW - Cytoreduction

KW - Feeding tube

KW - HIPEC

KW - Nutrition

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U2 - 10.1016/j.jss.2015.08.003

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