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Nutritional Considerations After Gastrectomy and Esophagectomy for Malignancy

  • Esophageal and Gastric Cancer
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

An Erratum to this article was published on 01 March 2011

Opinion statement

This article reviews various methods of assessing and managing post-gastrectomy or esophagectomy patients from a nutritional standpoint, by examining recent research focusing on assessment models, components of enteral feeding, timing of feeding, safety of enteral nutrition (EN) vs total parenteral nutrition (TPN), appetite stimulants, alternative treatments, and long-term care. Pre-, peri-, and post-operative nutrition represent a major prognostic indicator in patients undergoing a gastrectomy or esophagectomy for malignant cancer. An accurate initial nutrition assessment to determine risk, followed by close monitoring pre-operatively and early enteral feeding post-operatively, has been shown to have the most beneficial effects. The optimal delivery route for nutrition involves the use of EN with immune enhancing nutrients while avoiding TPN. In practice, TPN is reserved for patients with post-operative complications that delay enteral feeding for an extended time. While megace is commonly used as an appetite stimulant, the hormone ghrelin is another novel, safe, and efficacious treatment to improve appetite, increase by mouth (PO) intake, and minimize loss of weight and lean body mass. Although use of ghrelin is not yet common practice, as more studies are published, we predict that this will become a more common treatment. While complementary and alternative therapies are commonly employed in this patient population, more research needs to be done before incorporation into our mainstay of treatment. Long term, these patients continue to be at nutritional risk and therefore should be followed to optimize weight maintenance and prevent micronutrient deficiencies.

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Authors and Affiliations

  1. Georgetown University Hospital, Washington, DC, 20057, USA

    Amelia Baker RD LD CNSC & Leigh-Anne Wooten MS RD LD

  2. Dahlgren Memorial Library, Georgetown University Medical Center, Washington, DC, 20057, USA

    Michele Malloy MALIS

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  1. Amelia Baker RD LD CNSC
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  2. Leigh-Anne Wooten MS RD LD
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  3. Michele Malloy MALIS
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Correspondence to Amelia Baker RD LD CNSC.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s11864-011-0142-8

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Baker, A., Wooten, LA. & Malloy, M. Nutritional Considerations After Gastrectomy and Esophagectomy for Malignancy. Curr. Treat. Options in Oncol. 12, 85–95 (2011). https://doi.org/10.1007/s11864-010-0134-0

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