Correlations between preoperative malnutrition and septic complications of esophageal cancer surgery.

Eight measures were used to assess the nutritional status of 80 patients with esophageal cancer, 58 with gastric cancer, and 50 healthy controls. Postoperative complications were divided into three categories: septic, anastomotic leakage, and nonseptic. Protein-calorie malnutrition (PCM) of esophageal cancer patients was characterized by a greater depletion of arm muscle circumference (AMC) and body weight (BW) compared with findings in the gastric cancer patients. Average AMC, BW, triceps skinfold (TSF), and levels of retinol-binding protein (RBP) on admission were lower in patients who suffered fatal septic complications than in those who did not. The reduction of AMC, BW, and RBP was observed even after preoperative total parenteral nutrition (TPN). It is concluded that patients with a nutritional depletion as assessed by these measures on admission should be treated with preoperative TPN, and, if nutritional correction of these measures is poor, other perioperative therapy to prevent fatal septic complications should be given.