Impact of a designed dietary protocol, with specially tailored total parenteral nutrition, on post-gastrectomy dumping syndrome and patient outcome

Background
Gastrectomy patients are commonly unable to maintain nutritional status. The aim of the current study was to examine the impact of a designed dietary protocol on postoperative outcome of cancer patients undergoing gastrectomy.
Methods
Sixty adult male and female cancer patients was included, and divided into two equal and matched groups (study & control). Four data collection tools were used: sociodemographic data sheet, postgastrectomy complications assessment sheet, nutritional assessment sheet and wound assessment sheet. The study group patients received specially tailored total parenteral nutrition (TPN) within a nutritional/dietary protocol focussing on six small dry daily feeding meals (low carbohydrate, moderate protein, low fat).
Results
The mean anthropometric measurements did not differ significantly from admission to the last follow up time (23.7 ± 4.5 & 22.2 ± 1.1 for Body Mass Index (BMI), 14.4 ± 6.2 & 13.06 ± 6.0 for Triceps Skin Fold (TSF) and 21.5 ± 3.0 & 20.6 ± 2.9 for Mid Arm Muscle Circumference (MAMC), respectively), as compared to that of the control group who showed statistically significant differences (22.5 ± 4.3 & 18.8 ± 3.4 for BMI, 10.8 ± 8.1 & 10.2 & 7.8 for TSF, and 20.4 ± 1.9 & 19.4± 1.8 for MAMC, respectively). The mean laboratory investigations as well did not differ significantly from admission to the last follow up time (11.3 ± 2.2 & 10.5 ± 1.1 for hemoglobin, 3.6 ± 0.5 & 3.7 ± 0.2 for serum albumin, 6.7 ± 0.7 & 6.4 ± 0.5 for serum total protein, 135.9 ± 4.0 & 137 ± 5.9 for serum sodium, and 3.7 ± 0.6 & 3. 5 ± 0.3 for serum potassium, respectively) as compared to that of the control group who showed statistically significant differences (11.1 ± 2.1 & 7.9 ± 2.5 for hemoglobin, 3.7 ± 0.6 & 2.9 ± 1.3 for serum albumin, 6.4 ± 0.5 & 4.9 ± 0.5 for serum total protein, 137.9 ± 3.9 & 133 ± 4.7 for serum sodium, and 3.8 ± 0.3 & 3.3 ± 0.2 for serum potassium, respectively). Dumping syndrome affected the control group subjects more frequently than the study group ones.
Conclusion
Specially tailored TPN within a nutritional/dietary protocol was associated with less prevalence of significant weight loss, malnutrition and dumping syndrome in cancer patients undergoing gastrectomy as compared to control group.