[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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Appropriate preoperative nutrition management of malnourished patients or patients with a high risk of malnutrition improves their outcome. However, the current status of preoperative nutrition in Japan is unknown. We conducted an online survey of surgeons who implemented preoperative nutrition management for colorectal, gastric, and/or esophageal cancer patients within one year. In this survey, we asked about the status of preoperative nutrition management, choice of nutritional intervention in simulated cases, and the recognitions of peripheral parenteral nutrition. Regarding nutritional assessment, the markers of visceral protein status, such as the serum albumin level, are no longer considered preferable. However, we found that blood test data（e.g. albumin and rapid turnover protein）are still commonly used to assess nutritional status in addition to body weight and body mass index in this survey. According to the results of the simulated case‐based questionnaire, nutrition management is conducted depending on the nutritional status and feeding conditions of patients. Although oral nutritional supplements（ONS）are the first choice for nutritional intervention when feasible, tube feeding and/or parenteral nutrition are also considered and implemented if the adherence to ONS is low or if ONS are infeasible. Our survey clarified the current status of preoperative nutrition. The indications, as well as specific and pragmatic methods of preoperative nutrition management need to be reconsidered based on these results.

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We provided in‐hospital‐dispensed selenium injections（Se）to home parenteral nutrition（HPN）patients with hyposelenemia until commercial Se products became available in 2019. Subject and methods：At the end of 2019, we retrospectively examined 27 of 50 HPN patients who visited our hospital and were prescribed Se preparations for more than 6 months regarding the amount of Se used, the duration of use, changes in serum Se levels, and the presence of adverse events. Results：Patients ranged in age from 2 to 78 years（median 22 years）．Seventeen of the patients were older than 16 years of age. The most common underlying disease was short bowel disease, with daily Se doses ranging from 25 to 200 μg/dL/day（4 μg/kg/day）．The daily Se dose was higher than the marketed formulation（2 μg/kg/day）and ranged from 25 to 200 μg/dL/day（4 μg/kg/day）．The blood level of Se（normal：13‐20 μg/dL）was maintained at 8.3‐23 μg/dL（median：14.8 μg/dL）．Although variation was noted in the values, no adverse events were observed. In summary, the need of Se preparations by HPN patients was higher and more prolonged than prescribed. Although provision of the in‐hospital product ended after the commercial Se product became available, adjustment of the dose according to patient needs may be required.

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We investigated factors associated with catheter‐related bloodstream infection（CRBSI）and the nutritional status following the implantation of a totally implantable central venous catheter port（CV port）in 412 patients at our hospital. We measured the prognostic nutritional index（PNI）, Controlling Nutritional Status（CONUT）, and serum Alb as indicators. Of the 412 patients, 14 developed CRBSI. At the time of implantation of the CV port, there was no significant difference in the patient characteristics or nutritional status based on all three indicators between the group with CRBSI（Group I）and that without（Group N）, The causative bacteria in most cases were staphylococci and Candida sp．The number of patients who received intravenous nutrition therapy increased when CRBSI occurred. As the nutritional status of Group I was maintained until the onset of CRBSI, we hypothesized that CRBSI is due to port handling rather than the increased susceptibility to infection because of malnutrition. Appropriate port management with proper hand hygiene and education is essential to prevent CRBSI.

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