Impact of Nutritional Therapy in the Post-Operative Period of Patients Undergoing Gastrectomy for Gastric Adenocarcinoma: A Systematic Review
Objective: To understand and identify the beneficial determining factors in nutritional intervention and management in the treatment of patients with gastric adenocarcinoma undergoing gastrectomy. Method: This study was carried out based on searches in the PubMed, LILACS and SciELO databases, published between 2008 and 2023 in English, Portuguese and Spanish. The following descriptors were used in Portuguese: gastric adenocarcinoma, gastrectomy, oral nutritional therapy with emphasis on the postoperative period, descriptors in English: gastric adenocarcinoma, gastrectomy, oral nutritional therapy with emphasis on the postoperative period, and descriptors in Spanish: gastric adenocarcinoma, gastrectomía, terapia alimentacional oral com enfoque no pós-operativo. The following inclusion criteria were used to select the articles: articles published in full, including a bibliographic review, systematic review, meta-analysis and clinical trial with approaches focused on nutritional therapy in patients with gastric adenocarcinoma undergoing gastrectomy. The exclusion criteria were: Theses, dissertations and publications not related to the theme of the study. Results: Of the 38 articles searched, 8 studies that met the inclusion criteria were identified, involving: nutritional management after gastrectomy surgery in patients with gastric adenocarcinoma. The studies analyzed involved 963 patients with an average study time of 10 months. Discussion: The studies report that prolonged perioperative fasting is a common practice in medical teams, compromising the food and nutritional safety of surgical patients. The practice, which is oblivious to nutritional risk factors, such as age, comorbidities and dietary supply, indicates the need to review fasting protocols in Brazilian hospitals. It is recommended to adopt protocols that promote the abbreviation of fasting to improve quality of life, reduce complications and hospital costs, and promote a more efficient and humanized recovery. Conclusion: This review confirms the benefits of the nutritional therapy approach and early reintroduction of the diet in gastrointestinal surgeries. The benefits of early oral nutrition are still debatable, but studies have already shown that early feeding up to 48 hours can be beneficial, as it reduces infectious complications, hospital stay, contributes to the healing of the anastomosis and faster recovery.
