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LiFE re

Literature for ENYGO

Nutritional support/status in gynaecological cancer

Editor Jiri Presl Wijk et al., in their single centre prospective cohort study, compared
outcomes among 121 consecutive patients undergoing abdominal
Descriptive summary hysterectomy and salpingo-oophorectomy for malignant or benign
indications between 2012 and 2014. No difference was found, not
The first cited papers are recently published ERAS /Enhanced in terms of LOS nor complications, reoperations, or readmissions.
Recovery After Surgery/ Society guidelines applied in gynaecologic/ The ERAS protocol may be equally applicable to patients undergoing
oncology surgery. The recommendations are divided into two parts. hysterectomy for malignant or for benign disease.
Part I deals with pre- and intraoperative care. It mentions items such
as preoperative information education and counselling, preoperative Purcell et al. reviewed the impact of body weight and particularly
optimization, bowel preparation, fasting and carbohydrate treatment, body composition on surgical complications, morbidity, chemother-
preanaesthetic medication, thromboembolism prophylaxis, antimi- apy dosing and toxicity (as predictors of prognosis), and survival in
crobial prophylaxis and skin preparation, anaesthetic protocol, PONV, ovarian cancer patients. They conclude that body composition, as an
MIS, nasogastric intubation, preventing intraoperative hypothermia, indicator of nutritional status, is a better prognostic tool than body
and perioperative fluid management. weight or BMI alone in ovarian cancer patients.

Part II deals with postoperative care and covers items such as
prophylaxis against thromboembolism, fluid therapy, nutritional care,
prevention of postoperative ileus, postoperative glucose control and
analgesia, peritoneal and urinary drainage, and early mobilization.

The evidence base, recommendations, evidence level, and recom-
mendation grade are provided for each individual ERAS item. The
whole protocol combines unimodal evidence-based interventions
aiming to enhance recovery after surgery and reduce length of stay.

De Groot et al. published a systematic review and meta-analysis of
31 records up to June 2014 on the current evidence of ERAS on post-
operative outcome in women undergoing open gynaecologic surgery.
Enhanced recovery pathways may reduce length of postoperative
hospital stay in abdominal gynaecologic surgery.

Relevant articles retrieved Nov 2015 - Feb 2016

No Title Authors Journal Link to abstract
Gynecol Oncol.
1 Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Nelson G et al. Gynecol Oncol. http://www.ncbi.nlm.nih.gov/
Enhanced Recovery After Surgery (ERAS®) Society recommendations - Part I. Acta Obstet Gynecol Scand. pubmed/26603969
Gynecol Obstet Invest.
2 Guidelines for postoperative care in gynecologic/oncology surgery: Enhanced Nelson G et al. Curr Oncol Rep. http://www.ncbi.nlm.nih.gov/
Recovery After Surgery (ERAS®) Society recommendations - Part II. pubmed/26757238

3 Enhanced recovery pathways in abdominal gynecologic surgery: a systematic de Groot JJ et al. http://www.ncbi.nlm.nih.gov/
review and meta-analysis. pubmed/26613531

4 Enhanced Recovery after Surgery Protocol in Abdominal Hysterectomies for Wijk L et al. http://www.ncbi.nlm.nih.gov/
Malignant versus Benign Disease. pubmed/26799328

5 Impact of Body Weight and Body Composition on Ovarian Cancer Prognosis. Purcell SA et al. http://www.ncbi.nlm.nih.gov/
pubmed/26769113

International Journal of Gynecological Cancer, Volume 26, Supplement #1 Page 68