Objective: To evaluate the utility of a clinical pathway (CP) that incorporates preoperative oral rehydration therapy and early postoperative oral intake into laparoscopic colon cancer surgery.

Methods: At the Division of Colon Surgery, Shizuoka Cancer Center, laparoscopic surgery for colon cancer was performed in 246 patients on the conventional CP with preoperative fasting (control group) and 255 patients on a newly established CP that incorporated preoperative oral rehydration therapy and early postoperative oral intake (enhanced nutrition group). Energy balance was compared between the groups.

Results: Compared with the control group, the enhanced nutrition group showed significant improvements in weight loss, total energy supply, and oral caloric intake and significant reductions in the calories provided by parenteral nutrition feeds and the number of such feeds needed (all P<0.0001). The number of deviations from the CP did not differ significantly between the groups (P=0.1112).

Conclusion: The newly established CP appears to be more useful in improving energy balance and conserving medical resources in patients undergoing laparoscopic surgery for colon cancer.

Background: CONUT (Controlling nutritional status) is a useful tool for preoperative nutritional evaluation. The relationship between the preoperative nutritional status and the postoperative complications of pancreatoduodenectomy has not yet been fully understood. The purpose of this study is to determine whether the preoperative nutritional status relates to the postoperative complications.

Methods: Preoperative CONUT scores of total 374 patients before pancreatoduodenectomy were compared to the postoperative complications, including surgical site infection, postoperative pancreatic fistula, and general postoperative complications graded by Clavien-Dindo classification.

Results: The preoperative nutritional status of 374 patients who underwent pancreatoduodenectomy was assessed by CONUT, 133 patients were judged as normal nutrition, 192 patients as mild malnutrition, and 49 patients as moderate malnutrition. No significant relation was observed between the preoperative nutritional status and the postoperative complications. Subgroup analysis with pancreatic texture revealed that postoperative complications by Clavien Dindo classification was significantly higher in the cases of malnutrition than normal in the population of the hard pancreas, where postoperative pancreatic fistula is rare (p=0.02). The postoperative complication was also high in the impaired nutrition group, when analyzed only in the cases without postoperative pancreatic fistula.

Conclusion: This study showed that impaired preoperative nutrition related to postoperative complications in the cases without pancreatic fistula. Preoperative nutritional improvement might reduce the postoperative complications.

Aim: It was aimed in this study to clarify the clinical usefulness of blenderized foods we developed with Base Rice in neurologically handicapped pediatric and adult patients.

Methods: Comparative analyses of BMI, serum albumin, and total calorie intake before and after the introduction of our blenderized foods were conducted in 28 handicapped patients. Questionnaire survey regarding the blenderized foods of patients’ gurdians was also performed.

Results: Total calorie intake and serum albumin increased significantly in 17 patients with and 10 without water-added blenderized foods, respectively. BMI did not change significantly. Stool appearance and emesis were improved in a subset of the patients. Questionnaire survey reported that the blenderized foods were satisfactory and effortless for most of the guardians.

Conclusion: Blenderized foods we developed with Base Rice were considered to be clinically useful in the gastrostomy feeding of neurologically handicapped pediatric and adult patients.