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Nutrients
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Nutritional Intervention in Upper GI and Pancreas Surgery
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Nutritional Intervention in Upper GI and Pancreas Surgery

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (30 June 2020) | Viewed by 19572

Special Issue Editor

Dr. Misha D. P. Luyer

E-Mail Website
Guest Editor
Department of Surgery, Catharina Hospital, 5623 Eindhoven, The Netherlands
Interests: upper GI surgery; pancreatic surgery; nutrition; inflammation; minimally invasive surgery; enhanced recovery after surgery; robotic surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nutrition has gained a prominent role in postoperative recovery and has been embedded in clinical care pathways in various types of abdominal surgery. The beneficial effect of adequate preoperative nutritional assessment and early start of nutrition postoperatively on postoperative outcomes and modulation the surgical stress response are important driving factors. However, for esophageal, gastric (Upper GI), and pancreatic surgery, the exact role of nutrition has been a subject of discussion. The reasons for this may be variable: Many patients undergoing upper GI or pancreatic surgery have cancer with associated symptoms of partial or complete obstruction resulting in weight loss or malnutrition. Furthermore, this type of surgery is associated with major complications such as anastomotic leakage, pulmonary complications and gastroparalysis that have a direct impact on the type and especially the route of nutritional support. 

In this Special Issue of Nutrients, entitled “Nutritional Intervention in Upper GI and Pancreas surgery”, submissions of manuscripts describing original research, reviews of the scientific literature systematic reviews or meta-analyses are welcomed that elaborate on the role of nutrition in Upper GI and Pancreas surgery patients.

Dr. Misha D. P. Luyer
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Esophagectomy
  • Gastrectomy
  • Pancreatectomy
  • Nutrition
  • Recovery

Published Papers (4 papers)

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Research

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10 pages, 219 KiB  
Article
Needle Catheter Jejunostomy in Patients Undergoing Surgery for Upper Gastrointestinal and Pancreato-Biliary Cancer–Impact on Nutritional and Clinical Outcome in the Early and Late Postoperative Period
by Maria Wobith, Lena Wehle, Delia Haberzettl, Ali Acikgöz and Arved Weimann
Nutrients 2020, 12(9), 2564; https://doi.org/10.3390/nu12092564 - 25 Aug 2020
Cited by 21 | Viewed by 3366
Abstract
The metabolic risk for patients undergoing abdominal cancer resection increases in the perioperative period and malnutrition may be observed. In order to prevent further weight loss, the guidelines recommend for high-risk patients the placement of a needle catheter jejunostomy (NCJ) for supplementing enteral [...] Read more.
The metabolic risk for patients undergoing abdominal cancer resection increases in the perioperative period and malnutrition may be observed. In order to prevent further weight loss, the guidelines recommend for high-risk patients the placement of a needle catheter jejunostomy (NCJ) for supplementing enteral feeding in the early and late postoperative period. Our aim was to evaluate the safety of NCJ placement and its potential benefits regarding the nutritional status in the postoperative course. We retrospectively analyzed patients undergoing surgery for upper gastrointestinal cancer, such as esophageal, gastric, and pancreato-biliary cancer, and NCJ placement during the operation. The nutritional parameters body mass index (BMI), perioperative weight loss, phase angle measured by bioelectrical impedance analysis (BIA) and the clinical outcome were assessed perioperatively and during follow-up visits 1 to 3 months and 4 to 6 months after surgery. In 102 patients a NCJ was placed between January 2006 and December 2016. Follow-up visits 1 to 3 months and 4 to 6 months after surgery were performed in 90 patients and 88 patients, respectively. No severe complications were seen after the NCJ placement. The supplementing enteral nutrition via NCJ did not improve the nutritional status of the patients postoperatively. There was a significant postoperative decline of weight and phase angle, especially in the first to third month after surgery, which could be stabilized until 4–6 months after surgery. Placement of NCJ is safe. In patients with upper gastrointestinal and pancreato-biliary cancer, supplementing enteral nutrition during the postoperative course and continued after discharge may attenuate unavoidable weight loss and a reduction of body cell mass within the first six months. Full article
(This article belongs to the Special Issue Nutritional Intervention in Upper GI and Pancreas Surgery)
11 pages, 435 KiB  
Article
Micronutrient Deficiencies Following Minimally Invasive Esophagectomy for Cancer
by Henricus J.B. Janssen, Laura F.C. Fransen, Jeroen E.H. Ponten, Grard A.P. Nieuwenhuijzen and Misha D.P. Luyer
Nutrients 2020, 12(3), 778; https://doi.org/10.3390/nu12030778 - 15 Mar 2020
Cited by 9 | Viewed by 3908
Abstract
Over the past decades, survival rates for patients with resectable esophageal cancer have improved significantly. Consequently, the sequelae of having a gastric conduit, such as development of micronutrient deficiencies, become increasingly apparent. This study investigated postoperative micronutrient trends in the follow-up of patients [...] Read more.
Over the past decades, survival rates for patients with resectable esophageal cancer have improved significantly. Consequently, the sequelae of having a gastric conduit, such as development of micronutrient deficiencies, become increasingly apparent. This study investigated postoperative micronutrient trends in the follow-up of patients following a minimally invasive esophagectomy (MIE) for cancer. Patients were included if they had at least one postoperative evaluation of iron, ferritin, vitamins B1, B6, B12, D, folate or methylmalonic acid. Data were available in 83 of 95 patients. Of these, 78.3% (65/83) had at least one and 37.3% (31/83) had more than one micronutrient deficiency at a median of 6.1 months (interquartile range (IQR) 5.4–7.5) of follow-up. Similar to the results found in previous studies, most common deficiencies identified were: iron, vitamin B12 and vitamin D. In addition, folate deficiency and anemia were detected in a substantial amount of patients in this cohort. At 24.8 months (IQR 19.4–33.1) of follow-up, micronutrient deficiencies were still common, however, most deficiencies normalized following supplementation on indication. In conclusion, patients undergoing a MIE are at risk of developing micronutrient deficiencies as early as 6 up to 24 months after surgery and should therefore be routinely checked and supplemented when needed. Full article
(This article belongs to the Special Issue Nutritional Intervention in Upper GI and Pancreas Surgery)
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Review

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15 pages, 253 KiB  
Review
The Role of Immunonutrition in Patients Undergoing Pancreaticoduodenectomy
by Beata Jabłońska and Sławomir Mrowiec
Nutrients 2020, 12(9), 2547; https://doi.org/10.3390/nu12092547 - 23 Aug 2020
Cited by 22 | Viewed by 4585
Abstract
Pancreaticoduodenectomy (PD) is one of the most difficult and complex surgical procedures in abdominal surgery. Malnutrition and immune dysfunction in patients with pancreatic cancer (PC) may lead to a higher risk of postoperative infectious complications. Although immunonutrition (IN) is recommended for enhanced recovery [...] Read more.
Pancreaticoduodenectomy (PD) is one of the most difficult and complex surgical procedures in abdominal surgery. Malnutrition and immune dysfunction in patients with pancreatic cancer (PC) may lead to a higher risk of postoperative infectious complications. Although immunonutrition (IN) is recommended for enhanced recovery after surgery (ERAS) in patients undergoing PD for 5–7 days perioperatively, its role in patients undergoing pancreatectomy is still unclear and controversial. It is known that the proper surgical technique is very important in order to reduce a risk of postoperative complications, such as a pancreatic fistula, and to improve disease-free survival in patients following PD. However, it has been proven that IN decreases the risk of infectious complications, and shortens hospital stays in patients undergoing PD. This is a result of the impact on altered inflammatory responses in patients with cancer. Both enteral and parenteral, as well as preoperative and postoperative IN, using various nutrients, such as glutamine, arginine, omega-3 fatty acids and nucleotides, is administered. The most frequently used preoperative oral supplementation is recommended. The aim of this paper is to present the indications and benefits of IN in patients undergoing PD. Full article
(This article belongs to the Special Issue Nutritional Intervention in Upper GI and Pancreas Surgery)

Other

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17 pages, 332 KiB  
Discussion
The Relevance of Thiamine Evaluation in a Practical Setting
by Federico Pacei, Antonella Tesone, Nazzareno Laudi, Emanuele Laudi, Anna Cretti, Shira Pnini, Fabio Varesco and Chiara Colombo
Nutrients 2020, 12(9), 2810; https://doi.org/10.3390/nu12092810 - 13 Sep 2020
Cited by 18 | Viewed by 7344
Abstract
Thiamine is a crucial cofactor involved in the maintenance of carbohydrate metabolism and participates in multiple cellular metabolic processes. Although thiamine can be obtained from various food sources, some common food groups are deficient in thiamine, and it can be denatured by high [...] Read more.
Thiamine is a crucial cofactor involved in the maintenance of carbohydrate metabolism and participates in multiple cellular metabolic processes. Although thiamine can be obtained from various food sources, some common food groups are deficient in thiamine, and it can be denatured by high temperature and pH. Additionally, different drugs can alter thiamine metabolism. In addition, the half-life of thiamine in the body is between 1 and 3 weeks. All these factors could provide an explanation for the relatively short period needed to develop thiamine deficiency and observe the consequent clinical symptoms. Thiamine deficiency could lead to neurological and cardiological problems. These clinical conditions could be severe or even fatal. Marginal deficiency too may promote weaker symptoms that might be overlooked. Patients undergoing upper gastrointestinal or pancreatic surgery could have or develop thiamine deficiency for many different reasons. To achieve the best outcome for these patients, we strongly recommend the execution of both an adequate preoperative nutritional assessment, which includes thiamine evaluation, and a close nutritional follow up to avoid a nutrient deficit in the postoperative period. Full article
(This article belongs to the Special Issue Nutritional Intervention in Upper GI and Pancreas Surgery)
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