NUTRITIONAL SUPPORT ASPECTS WITH FAST TRACK PROGRAMME IN PLANNED SURGERIES FOR COLON CANCER IN ELDERLY PATIENTS

Goal: to develop and evaluate the efficiency of the tactics for peri-operative nutritional-metabolic therapy as a component of Fast Track programme (FTP) in elderly patients suffering from colon cancer and having planned surgery. Methods. Treatment outcomes were analyzed for 400 elderly patients with colon cancer divided into two groups: main group (prospective n = 170), who were treated complying with optimized FTP and nutritional-metabolic therapy and control group (retrospective, n = 230), who were managed in the traditional way. Peri-operative nutritional-metabolic therapy in the main group included detection of those initially suffering from protein-calorie deficiency basing on changes in body mass loss and body weight index, and provision of integral nutritional support for them. During pre-operative preparation period lasting from 10 to 14 days they were prescribed with residue-free diet additionally to which, depending on the volume of food consumed by sipping, they received liquid nutritional mixture (Impact® Oral, Nestle) with high protein (7.6 g per 100 ml) and calories (1.4 kcal in ml) content. Post-operative nutritional support included early (from the 1st day after the surgery) enteral feeding with use of standard multisubstrate nutritional mixtures with protein content of 40g/l (Isosource® Standard, Nestle) in order to prevent paresis of gastro-intestinal tract combined with early activation of patients. Results. Patients in the main group confidently earlier restored the protein pool and immune status, nasogastric tube was removed faster, the duration of stay in the intensive care department and hospital after the surgery was less, the severity of complications as per Clavien – Dindo classification was lower, and life quality and late treatment outcomes were better. Conclusions. Use of the offered tactics of peri-operative nutritional-metabolic therapy as a component of FTP allowed speeding up rehabilitation and enhancing surgical and oncological outcomes in the burdened elderly patients having planned surgery due to colon cancer.

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