Influence of preoperative and postoperative nutritional therapy on the nutritional status of oncologic patients undergoing gastrectomy: a systematic review
DOI:
https://doi.org/10.55892/jrg.v8i19.2624Keywords:
Nutritional Support, Gastric Cancer, PerioperativeAbstract
Gastric cancer and its standard curative treatment, gastrectomy, are intrinsically linked to high rates of malnutrition and cachexia, serious conditions that compromise response to cancer treatment, increase morbidity and mortality, and reduce tolerance to therapy. Given the importance of nutritional status for better clinical outcomes and preservation of lean body mass, this study aimed to analyze the influence of pre- and postoperative nutritional therapy in these patients. This systematic review, conducted under the PRISMA guidelines, included 12 randomized, prospective clinical trials published between 2020 and 2025, focusing on nutritional therapy (oral, enteral, and parenteral) in adults and elderly patients undergoing gastrectomy for cancer. The findings reinforce the indispensable role of perioperative nutritional intervention. Evidence has shown that early oral feeding is safe and can accelerate recovery of bowel function and reduce hospital stays; post-discharge nutritional support with oral supplements and dietary counseling reduced long-term mortality in patients at nutritional risk; and multimodal prehabilitation programs reduced postoperative morbidity by 60%. Furthermore, immunonutrition (with arginine, -3, and nucleotides), when administered preoperatively or perioperatively, protected the intestinal mucosal barrier and significantly reduced infectious complications, especially in cachectic patients. We conclude that, despite the clear association between nutritional therapy and favorable clinical outcomes, gaps remain in the literature regarding standardization of protocols and the ideal timing and duration of interventions. This requires further high-quality, multicenter research to strengthen the clinical evidence base.
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References
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