PREDICTIVE FACTORS OF THE OUTCOME OF SURGICAL PROCEDURES FOR ENTERAL FEEDING IN PATIENTS WITH MALIGNANT VS. NONMALIGNANT DISEASES
Surgical feeding procedures are required as a treatment for malnutrition that occurs in a wide range of malignant or benign, digestive or extradigestive diseases. Choosing the best approach in each case is important for achieving a correct nutritional support. Aim: To identify the predictive factors of the efficacy of the different surgical feeding procedures, comparatively in benign vs. malignant pathology. Material and methods: Retrospective, cross-sectional, observational study of a group of 276 cases with various benign and malignant diseases. Correlations were established between the initial disease, type of surgical techniques for enteral feeding and the postoperative outcomes. Statistical analysis was performed using the Chi-square test for dichotomous variables and the Mann-Whitney and Kruskal-Wallis tests for ordinal and continuous variables. Results: Most patients with either benign or malignant digestive diseases underwent Gavriliu’s high gastrostomy with peritoneal cuff (73.6%; 91% respectively), performed under local anesthesia. The patients with benign extradigestive diseases and 35% of the patients with malignant extradigestive diseases underwent percutaneous endoscopic gastrostomy (PEG), but monitoring was short, 30 days, respectively. In early postoperative follow-up, PEG is associated with faster recovery and lower gastric stasis volume. Classic gastrostomy is still an option in cases with severe strictures due to esophageal or head and neck malignancies. The main long-term prognostic factor is the possibility of ensuring the correct number of calories and volume of food. Conclusions: The efficiency of feeding techniques is long-lasting, largely uninfluenced by the underlying disease. The acquisition of the nursing elements would makes it possible to maintain these surgical feeding solutions both in the hospital setting, but especially in the outpatient setting.
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