Surgical Metabolism and Nutrition最新文献_第3页

Relationship of the Psoas Muscle Index with the Other Nutritional Factors in Patients Who Underwent Emergency Operation with Colonic Perforation 急诊结肠穿孔手术患者腰肌指数与其他营养因子的关系

Surgical Metabolism and Nutrition Pub Date : 2018-12-30 DOI: 10.18858/SMN.2018.9.2.36

Young Hun Kim, K. Lee, K. Kim

{"title":"Relationship of the Psoas Muscle Index with the Other Nutritional Factors in Patients Who Underwent Emergency Operation with Colonic Perforation","authors":"Young Hun Kim, K. Lee, K. Kim","doi":"10.18858/SMN.2018.9.2.36","DOIUrl":"https://doi.org/10.18858/SMN.2018.9.2.36","url":null,"abstract":"Purpose: This study examined the correlation between the preoperative nutritional index and Sarcopenia in emergency colonic perforation patients. Materials and Methods: Patients undergoing an emergency operation with colorectal perforation at Chosun University Hospital between January 2014 and December 2016 were included in the analysis, and the medical records were reviewed retrospectively. Sarcopenia was defined by the psoas muscle area measured by preoperative computed tomography (CT) cross sectional imaging at L3 vertebra. The clinical nutritional index of patients with PMI (psoas muscle index)-High group were compared with a PMI-Low group. Results: The median PMI of the males was 4.48 cm 2 /m 2 and the median of females was 3.33 cm 2 /m 2 (P=0.002) The PMI-High and PMI-Low groups were not correlated with age and gender (P=0.455 and P=0.806, respectively). The traditional indicators of the nutritional status, such as body mass index (BMI), albumin, and lymphocytes, were not associated with sarcopenia (P=0.094, P=0.676, and P=1.000, respectively). No significant difference was observed between the ASA classification and sarcopenia (P=0.145). Conclusion: Sarcopenia using PMI was not associated with previous nutritional indices in patients undergoing emergency surgery due to colonic perforation. In the future, large-scale studies will need to identify its role as a prognostic factor. (Surg Metab Nutr 2018;9:36-40)","PeriodicalId":147842,"journal":{"name":"Surgical Metabolism and Nutrition","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116295085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is Postoperative Albumin Level Related with Surgical Site Infection? 术后白蛋白水平与手术部位感染有关吗?

Surgical Metabolism and Nutrition Pub Date : 2018-12-30 DOI: 10.18858/SMN.2018.9.2.59

K. Cho, Sungwoo Cho, Sangchul Yun, Suyeon Park

{"title":"Is Postoperative Albumin Level Related with Surgical Site Infection?","authors":"K. Cho, Sungwoo Cho, Sangchul Yun, Suyeon Park","doi":"10.18858/SMN.2018.9.2.59","DOIUrl":"https://doi.org/10.18858/SMN.2018.9.2.59","url":null,"abstract":"Purpose: Surgical site infection (SSI) is a hospital-acquired infection (HAI) associated with increased mortality, length of hospital stay, and cost of hospitalization. The aim of this study was to identify the value of albumin as an indicator of the nutritional status, postoperative C-reactive protein (CRP), and white blood cell (WBC) levels in predicting an outbreak of SSI and SSI-related epidemiology after colorectal surgery and identifying the risk factors for SSI. Materials and Methods: A total of 198 patients, who underwent colorectal surgery from September 1, 2015 to December 31, 2016, were included in the study. The patient identity, operation characteristics, and SSI data were analyzed retrospectively by a chart review and national SSI reporting sheet. The relationship of the SSI and clinical data was analyzed statistically, and the SSI detection time and post-operative inflammatory laboratory findings were analyzed individually using cumulative incidence analysis and cause-specific hazard model. Results: The incidence of SSI post colorectal surgery was 15.7% (31 out of 198 cases). Chronic renal failure (CRF), open surgery, long operation time, and stoma were identified as significant risk factors for SSI using univariate analysis. The CRF, long operation time, and stoma were significant risk factors according to multivariate analysis. The decrease in albumin on post-operative day (POD)#3 and CRP elevation on POD#4 were related to the early detection of SSI. Conclusion: The actual incidence of SSI might be higher than expected, particularly in cases where patients have several clinical and operative factors. In addition, the albumin level and multiple postoperative inflammation tests can be employed as an early predictors of SSI. (Surg Metab Nutr 2018;9:59-67)","PeriodicalId":147842,"journal":{"name":"Surgical Metabolism and Nutrition","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134557899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Parenteral Glutamine Supplementation, Is It Optimal or Not? 肠胃外补充谷氨酰胺是否最佳?

Surgical Metabolism and Nutrition Pub Date : 2018-06-30 DOI: 10.18858/SMN.2018.9.1.5

D. Shin

{"title":"Parenteral Glutamine Supplementation, Is It Optimal or Not?","authors":"D. Shin","doi":"10.18858/SMN.2018.9.1.5","DOIUrl":"https://doi.org/10.18858/SMN.2018.9.1.5","url":null,"abstract":"Glutamine is a conditionally essential amino acid in the body because it falls into a shortage of supply during the catabolic state. Glutamine plays a key role in the gut function, immune system, and other essential processes in the body. A number of small randomized controlled trials have demonstrated positive clinical outcomes of a glutamine treatment, such as the ICU length of stay, and hospital mortality with glutamine supplementation. On the other hand, recent reports of large scale randomized controlled trials assessing the efficacy of glutamine supplementation demonstrated some negative effects and the main conclusions were a trend toward an increased 28-day mortality and significantly increased hospital stay and 6-month mortality in those who received glutamine. With such results, many academic societies have recommended that IV and enteral glutamine should not be used in a critical care setting based on the moderate quality of evidence available. The indiscriminate use of glutamine supplementation in critically ill patients with any type of organ failure can have deleterious effects. Nevertheless, more sophisticated and well-controlled larger studies will be needed to confirm how these moderate quality results are corrected and suggest the optimal usage of glutamine. More recent clinical trials have focused on specific populations and demonstrated benefits in burn and elective surgery patients with glutamine supplementation. The poor correlation between the plasma glutamine concentration and tissue concentration evoke scattered knowledge about glutamine treatments. A better understanding of the glutamine metabolism and proper guidelines for supplementation are expected. (Surg Metab Nutr 2018;9:5-10)","PeriodicalId":147842,"journal":{"name":"Surgical Metabolism and Nutrition","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129178146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Early Experience with Serial Transverse Enteroplasty in a Korean Intestinal Rehabilitation Team 韩国肠道康复小组的早期连续横切肠成形术经验

Surgical Metabolism and Nutrition Pub Date : 2018-06-30 DOI: 10.18858/SMN.2018.9.1.11

J. Hong, S. Yun, Sang Hoon Lee, Hyun Jung Kim, H. Park, Jeong-Meen Seo

{"title":"Early Experience with Serial Transverse Enteroplasty in a Korean Intestinal Rehabilitation Team","authors":"J. Hong, S. Yun, Sang Hoon Lee, Hyun Jung Kim, H. Park, Jeong-Meen Seo","doi":"10.18858/SMN.2018.9.1.11","DOIUrl":"https://doi.org/10.18858/SMN.2018.9.1.11","url":null,"abstract":"Purpose: For patients with short bowel syndrome, surgery can play an important role in the management of intestinal failure (IF). Serial transverse enteroplasty (STEP) has become a popular choice of bowel lengthening among surgeons for its safety and effectiveness in improving enteral autonomy. In this study, we report 5 cases of STEP procedure on 4 patients. Materials and Methods: In the Intestinal Rehabilitation Team at Samsung Medical Center, all patients were managed by a multidisciplinary team specialized in the care of intestinal failure patients. Retrospective review of medical records was performed. Results: 3 patients were children and 1 patient was an adult. Improvement in enteral autonomy was achieved in all patients following each STEP procedure. Suspected suture line leakage was seen in one patient, which was successfully managed by conservative treatment There were no other serious complications related to the procedures. Conclusion: STEP procedure continues to be an important management option in intestinal rehabilitation of patients with extreme short bowel. We report a small series of STEP performed safely and effectively in Korea. (Surg Metab Nutr 2018;9:11-15)","PeriodicalId":147842,"journal":{"name":"Surgical Metabolism and Nutrition","volume":"163 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127556014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Effect of Total Parenteral Nutrition Therapy in Palliative Gastrojejunostomy Status Patients 全肠外营养治疗在姑息性胃空肠吻合术患者中的作用

Surgical Metabolism and Nutrition Pub Date : 2018-06-30 DOI: 10.18858/SMN.2018.9.1.26

Yung Kil Kim, G. Song, T. Ahn, M. Son, S. Han, Joon-Hwan Song, H. Kim, S. Bae, S. Kim, M. Baek, Moon-Soo Lee

{"title":"Effect of Total Parenteral Nutrition Therapy in Palliative Gastrojejunostomy Status Patients","authors":"Yung Kil Kim, G. Song, T. Ahn, M. Son, S. Han, Joon-Hwan Song, H. Kim, S. Bae, S. Kim, M. Baek, Moon-Soo Lee","doi":"10.18858/SMN.2018.9.1.26","DOIUrl":"https://doi.org/10.18858/SMN.2018.9.1.26","url":null,"abstract":"Purpose: Gastric outlet obstruction (GOO) is a common problem associated with advanced malignancies of the upper gastrointestinal tract. Adverse events, such as malnutrition, can affect the quality of life, and gastrojejunostomy can be performed for palliative care. This study evaluated effects of total parenteral nutrition (TPN) therapy in post-operation state patients who underwent a palliative gastrojejunostomy (PGJ). Materials and Methods: Between January 2011 and June 2015, a total of 65 patients underwent PGJ at Soonchunhyang University Cheonan Hospital and all consecutive patients were included in this retrospective study. All patients were divided into the preoperative TPN group and non-TPN group. A nutritional status assessment included the body weight (BW), body mass index (BMI), CRP level, serum albumin, serum total protein, hemoglobin, and total lymphocyte count (TLC). Results: Thirty-one patients did not receive the TPN treatment, and 34 patients received the TPN treatment before surgery. Significant differences between preoperative and postoperative BW, BMI, CRP level, serum albumin, serum total protein, hemoglobin, and TLC were observed in the non-TPN group. On the other hand, there was no significant difference between the preoperative BW, BMI, TLC and postoperative BW, BMI, TLC in the TPN group (p=0.914, p=0.873, p=0.319). Conclusion: These results suggest that preoperative TPN therapy can improve the nutritional status in patients who underwent PGJ. (Surg Metab Nutr 2018;9:26-30)","PeriodicalId":147842,"journal":{"name":"Surgical Metabolism and Nutrition","volume":"131 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116336645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk of Malnutrition after Gastrointestinal Cancer Surgery: A Propensity Score Matched Retrospective Cohort Study 胃肠道肿瘤手术后营养不良的风险:倾向评分匹配的回顾性队列研究

Surgical Metabolism and Nutrition Pub Date : 2018-06-30 DOI: 10.18858/SMN.2018.9.1.16

S. Yoon, Bong-Hyeon Kye, Hyung-Jin Kim, K. Jun, Hyeon-Min Cho, H. Chin

{"title":"Risk of Malnutrition after Gastrointestinal Cancer Surgery: A Propensity Score Matched Retrospective Cohort Study","authors":"S. Yoon, Bong-Hyeon Kye, Hyung-Jin Kim, K. Jun, Hyeon-Min Cho, H. Chin","doi":"10.18858/SMN.2018.9.1.16","DOIUrl":"https://doi.org/10.18858/SMN.2018.9.1.16","url":null,"abstract":"Purpose: Patients with cancers arising from the gastrointestinal tract can suffer from nutritional inadequacies caused by various factors. This study investigated the risk of malnutrition after curative surgery in patients with gastric cancer (GC) or colorectal cancer (CRC) using various preoperative and postoperative nutritional screening tools. Materials and Methods: In the authors’ hospital, 407 patients (206 patients with GC and 201 patients with CRC) underwent surgery between July 2011 and June 2012. The patients from the two groups were matched using the propensity score and then analyzed the nutritional data from 170 patients (85 patients in each group), retrospectively. Results: In both groups, the postoperative nutritional status was impaired significantly compared to the preoperative status. The postoperative risk of undernutrition in CRC patients was significantly lower than that of the GC patients according to the Malnutrition Universal Screening Tool (P=0.007). At the time of hospital discharge after surgery, the incidence of a lower serum albumin level (P=0.002) and more than 5% weight loss (P=0.013) were higher in the GC group than in the CRC group. A comparison of the postoperative nutritional status among the types of surgery in each group, total gastrectomy in the GC group (P=0.015) and proctectomy with diverting stoma in the CRC group (P=0.06), were related to more than 5% weight loss. Conclusion: Gastrointestinal cancer surgery might increase the patients’ postoperative risk of malnutrition, particularly in GC surgery. Therefore, consecutive assessments of the nutritional status and appropriate nutritional support are necessary after surgery for GC and CRC. (Surg Metab Nutr 2018;9:16-25)","PeriodicalId":147842,"journal":{"name":"Surgical Metabolism and Nutrition","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130745957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Role of Postoperative Parenteral Nutrition in Elective Surgery; Selection of Patients and Conditions for Postoperative Parenteral Nutrition 术后肠外营养在择期手术中的作用术后肠外营养患者及条件的选择

Surgical Metabolism and Nutrition Pub Date : 2018-06-30 DOI: 10.18858/SMN.2018.9.1.1

Jong Won Kim

{"title":"Role of Postoperative Parenteral Nutrition in Elective Surgery; Selection of Patients and Conditions for Postoperative Parenteral Nutrition","authors":"Jong Won Kim","doi":"10.18858/SMN.2018.9.1.1","DOIUrl":"https://doi.org/10.18858/SMN.2018.9.1.1","url":null,"abstract":"Postoperative early enteral nutrition or early oral ingestion is recommended in surgical patients. In this situation, this study examined the role of parenteral nutrition in the postoperative period in patients undergoing elective surgery. The nutritional status should be assessed before surgery and in the case of malnutrition, nutritional support should be provided before surgery to obtain good results. More than 2 weeks of insufficient nutritional support after surgery may worsen the patient's progress. Therefore, it is recommended to start nutritional care if the oral intake is not appropriate until 7 days or 5 to 7 days after surgery. Enteral nutrition is related to the quick restoration of the bowel function and reduction of infection-related complications. Therefore, enteral nutrition has priority. On the other hand, depending on the patient's condition, it may not be possible to perform enteral nutrition, and the uniform implementation of the early enteral nutrition may be a burden to the patient. Parenteral nutrition has the advantage that it can supply nutrition without being affected by the intestinal condition, and it can be calculated to supply as much energy as required. The situation, where parenteral nutrition is required after elective surgery, could be summarized as 1) the patients who underwent nutritional therapy before surgery and could not tolerate oral intake or enteral nutrition after surgery. or 2) in the case where enteral nutrition did not satisfy 50% of the demand at 7 days after surgery, and it is judged that this situation should continue for 7 days. (Surg Metab Nutr 2018;9:1-4)","PeriodicalId":147842,"journal":{"name":"Surgical Metabolism and Nutrition","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125004769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0