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Early Oral Refeeding for Cancer patients undergoing Bowel Surgery

ABSTRACT: Interventions: This is a randomized clinical trial (RCT), parallel, of superiority. Participants will be randomized into blocks that result in equal sample sizes. Experimental group: 110 patients of both sexes with neoplasia submitted to colorectal surgery. Patients randomized to this group will receive within 24 hours of the postoperative, 100ml of clear liquid with progression of diet consistency every day of hospitalization. Control group: 110 patients with neoplasia submitted to colorectal surgery. Randomized patients will receive oral feeding only after the return of hydro-aerial noise, a practice adopted as a routine for patients of the referred surgery service, with progression of diet consistency every day of hospitalization until discharge. To reduce biases, the masking of the randomization procedure of the main surgeon before the surgical procedure and the patients participating in the research will be performed. Thus, the participants of the intervention group will receive liquid diet of proof (100 ml), in glass only with the identification of the patient (name and bed). In addition, the table containing the randomization of patients will be held by the main researcher in sealed and opaque envelopes, stored in a lockable cabinet. The follow-up of the outcomes will occur on the 7th and 30th postoperative days, being considered as primary outcomes the time (days) to achieve the estimated nutritional needs during hospitalization and weight evolution.;G07.203.650.240 Primary outcome(s): It is expected a decrease in time (days) to reach the nutritional needs estimated in cancer patients early fed after colorectal surgery;It is expected a reduction in weight loss on the 7th and 30th postoperative day in cancer patients who received early feedback after colorectal surgery

DISEASE(S): Colorectal Neoplasms. Colorectal Surgery. Perioperative Assistance

PROVIDER: 75118 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Treatment options and reliable predictive marker to determine patients at risk to develop postoperative LD and to define the optimal time point of liver resection are limited. Accordingly, there is an urgent need for an easily assessable preoperative test to predict postoperative liver function recovery, specifically as current markers are often expensive, time consuming and sometimes invasive. Emerging evidence suggests that microRNA (miRNA) signatures represent potent diagnostic, prognostic and treatment response biomarkers for several diseases. Using next-generation sequencing as an unbiased systematic approach 554 miRNAs were detected in preoperative plasma of 21 patients suffering from postoperative LD after liver resection and 27 matched controls. Subsequently, we identified a miRNA signature - consisting of miRNAs 151a-5p, 192-5p and 122-5p - that highly correlated with patients developing postoperative LD after liver resection. The predictive potential for postoperative LD was subsequently confirmed using real-time PCR in an independent validation cohort of 98 patients. Ultimately, a regression model of the two miRNA ratios 151a-5p to 192-5p and 122-5p to 151a-5p was found to reliably predict postoperative LD, severe morbidity, prolonged intensive care unit and hospital stay and even mortality prior to surgery with a remarkable accuracy, thereby outperforming established markers of postoperative LD. Ultimately, we documented that miRNA ratios closely followed liver function recovery after partial hepatectomy. Conclusion: Given the clinical relevance of predicting potentially fatal postoperative clinical outcome after liver resection, our data demonstrate the clinical utility of a novel miRNA-based biomarker to support the selection of patients undergoing partial hepatectomy. The dynamical changes during liver function recovery indicate a possible role in tailoring the optimal time point of surgery to each individual patient. Thereby, our data might help to tailor surgical strategies to the specific risk profile of individual patients.

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Early Oral Refeeding for Cancer patients undergoing Bowel Surgery

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