Aim: This study sought to clarify the clinical impact of perioperative malnutrition in patients with pancreatic cancer (PC).

Patients and Methods: A total of 255 eligible patients with PC who underwent resection at our hospital between 2007 and 2014 were evaluated in this single institutional retrospective observational study. Nutritional status before surgery and at discharge was evaluated using the Controlling Nutritional Status (CONUT) score; clinical and therapy-related factors as well as survival were compared between the groups according to perioperative nutritional status.

Results: Malnutrition was observed in 57% of all patients at discharge, which marked a significant increase (42% higher) than that before surgery (15%). Preoperative malnutrition was observed slightly more in older and male patients. There were no significant differences in tumor size or resectability, duration of hospital stay, receiving postoperative adjuvant therapy, and survival rate between patients with and without preoperative malnutrition. In contrast, patients with malnutrition at discharge demonstrated significantly longer operative duration (p<0.0001), more blood loss (p<0.0001), more frequent pancreatic head resection (p<0.0001) or combined vascular resection (p<0.0001), longer hospital stay (p<0.0001), and significantly shorter survival rate (p=0.041) compared with those without malnutrition at discharge. Multivariate regression analysis revealed significant associations of low serum cholesterol level (p=0.012), borderline resectability (p=0.035), long operative duration (p=0.021), excessive blood loss (p=0.049), and long hospital stay (p=0.0024) with malnutrition at discharge.

Conclusions: Prognosis after resection for PC was influenced more by nutritional status (malnutrition) at discharge than by preoperative malnutrition. Low serum cholesterol, borderline resectablility, long operative duration, excessive blood loss, and/or long hospital stay were significant risk factors for malnutrition at discharge, and nutritional assessment and intervention after discharge are important to further improve survival.

Background: Preterm infants born at 34 to 36 weeks of gestation, designated late-preterm infants, are considered to be at risk of nutritional imbalance. However, nutritional management for late-preterm infants, especially those born at 34 or 35 weeks of gestation, is not clearly established.

Methods: Subjects included 146 late-preterm infants born at 34 or 35 weeks of gestation who were admitted to our neonatal intensive care unit between January 2012 and June 2018. After classifying them into 2 groups, received combined nutritional therapy (CNT) including parenteral nutrition (CNT group) or received enteral nutrition(enteral nutrition group), we retrospectively compared nutritional management status and the effect of nutritional management on the infant’s physique.

Results: In total, 74 (97.4%) of the 76 late-preterm infants born at 34 weeks and 22 (31.4%) of the 70 late-preterm infants born at 35 weeks received CNT. Birth weight of those born at 35 weeks was significantly different between the CNT and enteral nutrition groups, but body weight at discharge was not significantly different between them. In the CNT group, body weight at discharge was similar, and physique at 3 months of age was not significantly different between those born at 34 weeks and those born at 35 weeks. No adverse events related to parenteral nutrition (PN) were observed.

Conclusions: CNT has the potential to correct the physical developmental disparity in late-preterm infants born at 34 or 35 weeks of gestation. The introduction of PN should be considered in such cases.

Purpose: Recent investigations have demonstrated that preoperative serum prealbumin (PreAlb) concentration is a useful predictor of postoperative complications after Gastrectomy. However, the association of serum PreAlb concentration with lung cancer surgery remains unclear. The aim of this study was to examine the association between the onset of postoperative respiratory complications and preoperative serum PreAlb level in patients who underwent lung cancer surgery.

Subjects and Methods: The medical records of primary lung cancer patients who underwent thoracoscopic lobectomy from January 2014 to December 2016 were retrospectively reviewed, and the clinicopathological features of these patients were compared between patients with and without postoperative respiratory complications. Furthermore, risk factors for postoperative respiratory complications were extracted using logistic regression analysis. Results: Among 449 patients, 29 patients (6.5%) developed postoperative respiratory complications. Both PreAlb and body mass index (BMI) values were significantly lower in patients with complications than in those without; the proportions of men, heavy smokers, and the prevalence of diabetes were significantly higher among patients with complications than those without. Multivariable analysis showed that PreAlb, BMI, and smoking index were significantly associated with the development of postoperative respiratory complications. Conclusion: The findings of our study suggested that low preoperative PreAlb level, in addition to low BMI and smoking index, would be a simple and useful factor for predicting the development of postoperative respiratory complications.

Background: Our hospital has had a full-time dietician on staff since 2015, but the impact of having a full-time dietician as a part of the postoperative care team has not been studied well. We retrospectively investigated short-term outcomes in patients who underwent pancreatoduodenectomy before and after having a full-time staff dietitian on staff.

Methods: We retrospectively investigated nutritional status, interventions, and postoperative morbidities in patients who underwent pancreaticoduodenectomy between 2013 and 2016. The patients were divided into 2 groups: before having a dietitian as a full-time staff member in the ward (pre group) and after (post group). We investigated nutrition intake (parenteral nutrition (PN), enteral nutrition, and total caloric intake), preoperative and postoperative nutritional status, duration of PN, and postoperative morbidities including catheter-related blood stream infection (CRBSI). Nutritional counseling was provided at the requested of the physician in the pre group but was provided regularly in the post group.

Results: There were 187 patients in the pre group and 230 in the post group. The post group received significantly less PN, more enteral nutrition, and more total calories than the pre group from postoperative days 7 to 14. Although there were no significant differences in preoperative nutritional status between the 2 groups, the prealbumin level tended to be higher in the post group than the pre group on postoperative day 14 (p=0.0502). The median duration of PN was shorter in the post group than the pre group (median 10 days vs. 12 days, respectively; p=0.001). The incidence of probable CRBSI was significantly lower in the post group than the pre group (1.3% vs. 4.8%, respectively; p=0.03), although incidence density differed between the groups (1.05 vs. 3.26/1000 line days, respectively).

Conclusions: Having a full-time dietitian in the ward increased total energy intake and prealbumin level on postoperative day 14, and reduced the incidence of probable CRBSI without increasing postoperative morbidities among patients who underwent pancreaticoduodenectomy.

Objectives: The objectives were twofold. In patients who received intervention from a nutrition support team (NST), we investigated (1) the association of tongue pressure and number of residual teeth with serum albumin values (Alb) and body mass index (BMI) and (2) evaluated the effect of tongue pressure and number of residual teeth on eating rate and meal form.

Subjects and Methods: Subjects were 27 inpatients who worked with the NST between February 2018 and January 2019. We analyzed correlations of tongue pressure and number of residual teeth with Alb, BMI, age, and eating rate after NST support was introduced. Next, we compared Alb, BMI, age, number of residual teeth, and eating rate between the low tongue pressure group (&lt;20 kPa) and the high tongue pressure group (≥20 kPa). In addition, we compared Alb, BMI, age, tongue pressure, number of residual teeth, and eating rate between the normal diet group and the modified diet group.

Results: Tongue pressure was positively correlated with eating rate and negatively correlated with age. Number of residual teeth was correlated with BMI. Tongue pressure and number of residual teeth were significantly decreased in the modified diet group compared with the normal diet group.

Conclusions: Tongue pressure had some influence on meal form and eating rate, while number of residual teeth affected meal form and BMI.