Implementation of perioperative nutritional care from the ACERTO Project in patients with colorectal cancer: feasibility and benefits.

INTRODUCTION

Cancer patients are more susceptible to compromised nutritional status, especially when undergoing surgery. Minimizing the metabolic response and muscle catabolism associated with surgical trauma and accelerating postoperative recovery are objectives of advanced recovery protocols such as the Accelerated Postoperative Total Recovery Project (ACERTO). In this context, the study aimed to implement and evaluate the feasibility and benefits of perioperative nutritional care recommended by ACERTO in an oncology hospital.

METHOD: Retrospective cohort study developed with adult and elderly patients with colorectal cancer undergoing laparotomy performed between 2018 and 2024. The study followed three phases: phase 1: ACERTO's pre-implementation data; phase 2: implementation of the ACERTO Project; and phase 3: ACERTO's post-implementation data. Demographic, clinical, surgical, and nutritional data, as well as outcomes, were collected in phases 1 and 3 and subjected to statistical analyses for comparison between the pre- and post-ACERTO phases.

RESULTS

275 pre-implantation and 101 post-implantation patient records were analyzed. Post-ACERTO patients were older (p=0.014), had higher body weight (p=0.002), higher BMI (p=0.012), and higher nutritional risk according to the NRS-2002 (p=0.015). Nutritional care improved after ACERTO implementation (p<0.05) and resulted in reduced postoperative IV fluids (p<0.001). Those who received less IV fluids had fewer complications (p=0.003). Also, after ACERTO implementation, those who were re-fed early (≤ 36 hours) had shorter hospital stays (p=0.006).

CONCLUSION

The results showed that the implementation of the ACERTO nutritional guidelines at HCCU proved feasible and with important benefits for patients..