Colorectal Tumor
Conditions
Keywords
vulnerable, nutrition, cancer, colorectal, tumor
Brief summary
Malnutrition priori a major abdominal surgery is frequent and increases morbidity and mortality. The management of malnutrition has an impact in reducing postoperative complications. However malnutrition is rarely detected and Guidelines infrequently followed. Recovery time and nutritional evaluation in elderly patients are major criteria in their postoperative management. Identifying malnutrition or malnutrition risk is fundamental to its treatment. It is therefore unsurprising that many validated tools for nutrition risk screening and nutrition assessment exist for the clinician to use in assisting with the accurate identification, referral and treatment of patients who are malnourished or at risk of malnutrition. And nutritional management must be adapted and based on this evaluation and evolution of the general status (Guidelines Grade A). A geriatric evaluation based on a screening of preoperative malnutrition should allow a better implementation of the European Society of Parenteral and Enteral Nutrition (ESPEN) guidelines.
Detailed description
Assessing the impact of a geriatric action (Team Mobile Geriatrics, EMG, or if the geriatric facility team when it does not have EMG) on the rate of nutritional support perioperative elderly subjects (≥ 70 years) who underwent a colorectal cancer according to ESPEN recommendations and SFNEP.
Interventions
* Multidisciplinary training sessions for malnutrition and malnutrition risk screening, postoperative nutritional procedures according to the ESPEN Guidelines * Preoperative Geriatric evaluation : eligibility criteria, nutritional status, previous history, comorbidities, clinical examination, activities of daily living (ADL) and Instrumental activities of daily living (IADL) * Implementation of an adapted nutritional support based on ESPEN Guidelines
Sponsors
Hospices Civils de Lyon
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Aged ≥ 70 years * Colorectal or tumor resection with/without synchronous metastases
Exclusion criteria
* Emergency resection of colorectal tumor * Unresectable colorectal tumor with/without synchronous metastases
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Perioperative nutritional management | During perioperative period From D-7 before date of hospitalization until discharge from the hospital, up to 30 days | Rate of nutritional support implemented in accordance with current European guidelines (ESPEN) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of preoperative nutritional management by immunonutrition implemented | During preoperative seven days | Nutritional management by immunonutrition implemented is based on a complete nutritional evaluation |
| Rate of malnourished patients | During preoperative seven days | Rate of malnourished patients is defined by the ESPEN criteria |
| Rate of patients with cachexia | Seventh day preoperative | Rate of patients with cachexia is defined by the French National Authority for Health (HAS) criteria |
| Malnutrition screening | During preoperative seven days | Rate of malnutrition screening procedure |
| Rate of postoperative nutritional management implemented | Postoperative follow-up until discharge from hospital, up to 30 days | Nutritional management implemented is based on the ESPEN guidelines |
| Evolution of the activities of daily living | During preoperative seven days and postoperative follow-up until discharge from hospital, up to 30 days | Variations of Activities of daily living (ADL) and Instrumental activities of daily living (IADL) scores |
| Postoperative complications | Postoperative follow-up until discharge from hospital, up to 30 days | Rate and type of postoperative complications (Grade I, II et IIIa of Dindo classification) |
Countries
France
Contacts
Primary ContactMarc BONNEFOY, PHD
Backup ContactLaurent VILLENEUVE
Outcome results
None listed