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A study of specialist dietetic input for patients requiring surgical resection for an oesophageal or gastric malignancy
Author(s) -
Roberts H.
Publication year - 2008
Publication title -
journal of human nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.951
H-Index - 70
eISSN - 1365-277X
pISSN - 0952-3871
DOI - 10.1111/j.1365-277x.2008.00881_39.x
Subject(s) - medicine , weight loss , dysphagia , malignancy , anorexia , general surgery , surgery , obesity
Background: Anorexia, weight loss and dysphagia are common symptoms in patients diagnosed with upper gastrointestinal (UGI) cancers. Research has shown that 80% of patients with UGI cancers will have a significant weight loss at the time of their diagnosis (Bruera, 1997). Actual dietetic input for this patient group has not been previously audited locally. The aim of this study was to compare the dietetic input received by patients with an oesophageal or gastric malignancy before and after appointment of a specialist upper gastrointestinal oncology (SUGO) dietitian. Methods: A retrospective survey examined the dietetic input for all patients requiring surgical resection for an oesophageal or gastric malignancy. Information was collected from dietetic record cards for patients that were seen by a dietitian between 1st October 2005 and 30th September 2006, the year before the SUGO dietitian was appointed. Information was collected by the same method from 1st November 2006 until 31st October 2007 for the first year the SUGO dietitian was in post. This last group of patients was asked to complete a patient satisfaction questionnaire approximately 8 weeks after surgery. Results: The effect of intervention by a SUGO dietitian is shown in Table 1. Pre and post operative weight loss in these patients was reduced after consultation with a SUGO dietiatin. 1 A summary of the main differences in patient management before and after appointment of a SUGO dietitian1 year pre‐appointment of SUGO dietitian 1 year post‐appointment of SUGO dietitianPre‐operative weight loss 7.3 (%) (average time 3.5 months) 3.2 (%) (average time 5.5 months) Number of patients seen by a dietitian prior to having a tumour resection (2–12 weeks before surgery) 1 (2.6%) 42 (67.7%) Post‐operative weight loss 14.4 (%) (average time 5.1 months) 7.6 (%) (average time 3.3 months) Percentage of patients who received dietary advice for home 60 (%) 100 (%) Percentage of patients seen as an inpatient by a dietitian following tumour resection 86 (%) 100 (%) Percentage of patients reviewed by a dietitian following discharge for a tumour resection 17.5 (%) 100 (%)Discussion: Appointing a SUGO dietitian has contributed to a 115% increase in the number of referrals for this patient group. Dietetic input with a SUGO dietitian before and after tumour resection has reduced percentage weight loss. This input included advice on a high energy and high protein diet, use of supplements and jejunostomy feeding. A SUGO dietitian helped to coordinate the dietetic input ensuring all patients receive the appropriate dietary advice. Conclusions: This showed that since appointing a SUGO dietitian patients with an oesophageal or gastric malignancy have better access to a specialist dietitian as well as the appropriate dietary advice throughout their treatment pathway. Reference Bruera, E. (1997) ABC of palliative care: anorexia, cachexia and nutrition. BMJ 315, 1219–1222.