Abstract:

ABSTRACT Preoperative nutritional assessment in patients undergoing major abdominal surgery: does being older limit radical surgery? The nutritional status of the patients who are subject to major abdominal surgery might be responsible for serious morbidity and mortality. Many surgeon refrain from radical surgery due to the same reasons in the elderly patients undergoing operation for cancer. Present prospective study aims to evaluate the effects of preoperative nutritional parameters on complications, duration of hospital stay and mortality in patients undergoing major abdominal surgery. Preoperative nutritional status of the thirty-seven patients, aged between 30-80 years undergoing elective major abdominal surgery for gastrointestinal cancer were evaluated by using anthropometric measurements and biochemical parameters. The patients were divided into two groups as those aged under 60 years (n=17) and those over 60 years (n=20) for comparison. There was no differences between the age groups regarding triceps skinfold thickness, mid-arm circumference, body mass index, nutritional risk index, weight loss, post operative hospital stay, complications and mortality. The rate of complications were 60% for older patients and 41% for those under 60 years old. While no relation was determined between preoperative nutritional parameters and existence of complication, the complications were correlated with male sex (14/24), continuous weight, post operative stay in the hospital and mortality and it statistical related with mortality only. Post operative hosoital stay 18(2-53) days in patients under 60 years and 17(7-65) days in patients above 60 years. In patients who stayed in hospital more than 7 days after operation, duration of stay significantly correlated with existence of complication and last-weight. In a total of six mortal patients, only two were over 60 years old. Mortality was correlated with smoking, duration of smoking, heart rate, white cell count and total billirubin levels (>10mg/dl) in preoperative period, and significant correlation was found with all these parameters. In conclusion, when elective major abdominal surgery was performed in patients with gastrointestinal cancer whose preoperative nutritional status were similar, age was not correlated with morbidity and mortality. Therefore, we suggest that radical surgery might be performed in elderly patients with gastrointestinal cancer as safe as it is being performed in younger patients.

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