15th Congress of the European Society of Surgical Oncology (ESSO), 15–17 September 2010, Bordeaux

Professor Christophe Mariette – University Hospital, Lille, France

Nutritional management before and after gastrointestinal surgery

The session today was about the importance of a nutritional approach and nutritional management in GI and ear, throat and nose cancer patients in order to have a better outcome from a medical and nutritional status point of view.

What were the main conclusions from this meeting?

The main conclusion is that nutrition status just before surgery is important to check; that nutritional support is quite important to implement in daily practice in order to enhance the post-operative course, especially for a GI cancer patient and especially regarding the infectious complication rate that is lower in patients that will benefit from pre- and post-operative nutritional supplements when compared to a malnourished patient without any nutritional support.

Is it important for patients to be aware of these nutritional factors?

I think that we need to have some degree of communication with patients since nutrition is a translational approach that will implement a medical approach for many days, many weeks or many months. We need to have the patient’s comprehension for a better approach and better results.

What were the main points of the talk you gave?

My talk was about the impact of immuno-nutrition in the perioperative setting since we know that nutritional support will improve the post-operative course but since 2000 we have some products that implement stronger nutrition with some micronutrients and this combination with vitamins, beta carotene, omega-3 fatty acids, glutamine and RNA will give better results and stronger entire nutrition. And through many randomised controlled trials and through fixed meta-analysis we definitely have a benefit in using pre-operative and perioperative immuno-nutrition both in malnourished and well-nourished patients in order to especially decrease the post-operative infectious complication rate in patients who are malnourished but also well-nourished in the pre-operative setting.

Do EU guidelines need to be updated in response to these findings?

The level of our guidelines is very high at the moment with the grade A level of recommendation and that is enough to promote such an approach with immuno-nutrition systematically in each hospital for each patient that will treat upper GI and GI cancer patients.