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abstract:
The impact of total parenteral nutrition on postoperative recovery in patients treated for advanced stage ovarian cancer
Objectives
Total
parenteral nutrition (TPN) presumably benefits cancer patients although
reports have disputed the significance of this nutritional
intervention. We sought to compare the postoperative outcomes of ovarian
cancer patients treated with either TPN or conservative management.
Methods
We
retrospectively evaluated the impact of TPN and conservative management
in ovarian cancer patients who underwent debulking surgery and a bowel
resection. The primary study variables encompassed patient time until
restoration of bowel function, number of postoperative complications and
duration of hospital stay.
Results
There were 147 subjects who were selected for this study. The patients who were treated with TPN (n = 69) demonstrated a longer time until restoration of bowel function (5.77 vs. 4.70 days; P < 0.001), experienced lower pre-operative albumin levels (2.22 vs. 2.97 g/dL; P < 0.001) and endured a significantly longer hospital stay (11.46 vs. 7.14 days; P < 0.001) compared to the conservative management (n = 78) cohort.
Conclusions
Postoperative
TPN in ovarian cancer patients may be inadvisable because of the
increased risk for complications. Moreover, in the hypoalbuminemic
patients, TPN may have not only delayed their postoperative recovery and
increased hospital stay duration, but further precipitated the
manifestation of nosocomial sequelae.
The term "nosocomial" comes from two Greek words: "nosus" meaning "disease" + "komeion" meaning "to take care of." Hence, "nosocomial" should apply to any disease contracted by a patient while under medical care. However, common usage of the term "nosocomial" is now synonymous with hospital-acquired.
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