Summary
In a prospective study including 60 patients with esophageal carcinoma the nutritional status was evaluated by means of anthropometric, biochemical and immunological data. As a first measure of malnutrition the diminuation of each single parameter was estimated in a 10%-scale, according to this a linear rising number of points given and the sum for all 11 parameters expressed as a score (Gofferje and Fekl). Second the nutritional status was judged by the prognostic nutritional index (Buzby and Mullen). Both score and index were correlated with serious postoperative complications (wound infection, anastomotic leakage, sepsis, organ failure, death). The results show that it was not possible to assess the risk of esophagectomy preoperatively on the ground of nutritional parameters solely. The reason could be that the nutritional status was rather normal in most cases and its risk burden therefore low. In conclusion performing preoperative nutritional therapy routinely seems not to be justified.
Zusammenfassung
In einer prospektiven Untersuchung von 60 Patienten mit Oesophagus-carcinom wurde der Ernährungsstatus anhand anthropometrischer, laborchemischer und immunologischer Daten bestimmt. Nach dem Vorschlag von Gofferje und Fekl wurde jeder Einzel-parameter entsprechend seiner Minderung in 10%-Stufen gewertet und mit einer linear ansteigenden Punktezahl belegt; die Summe aller 11 Einzelwerte gilt als Maß zur Beurteilung einer bestehenden Malnutrition. Als zweites Verfahren zur Einschätzung des Ernährungsstatus wurde der PNI (prognostic nutrition index) nach Buzby und Mullen verwendet. Sowohl Score als auch Index wurden in Beziehung gesetzt zu schwerwiegenden postoperativen Komplikationen (Wundheilungs-störung, Sepsis, Organinsuffizienz, Tod). Das Ergebnis zeigt, daß eine präoperative Risikoabschätzung aufgrund von Ernährungsparametern allein nicht möglich war. Grund hierfür ist wahrscheinlich der in den meisten Fällen noch zufriedenstellende Ernährungszustand, so daß die davon ausgehende Risikobelastung zu gering war. Deshalb erscheint auch eine routinemäßige operationsvorbereitende Ernährungstherapie nicht gerechtfertigt.
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Brandmair, W., Lehr, L. & Siewert, J.R. Ernährungsstatus beim Oesophaguscarcinom: Erfassung und Bedeutung für eine präoperative Risikoabschätzung. Langenbecks Arch Chiv 374, 25–31 (1989). https://doi.org/10.1007/BF01261932
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DOI: https://doi.org/10.1007/BF01261932