Research progress in perioperative nutritional risk screening and enteral nutritional support for liver cancer

doi:10.3877/cma.j.issn.2095-3232.2025.04.020

Abstract

Abstract:

Liver cancer is a common malignant tumor. Hepatectomy is the optimal treatment of liver cancer. Patients with liver cancer develop varying degrees of liver function impairment before surgery, leading to abnormal substance metabolism. After hepatectomy, patients experience severe surgical trauma and intense stress response, and often suffer from malnutrition. Perioperative malnutrition in patients with liver cancer will suppress the body’s repair ability, affect clinical prognosis and reduce the quality of life of patients. Therefore, it is of significance to provide perioperative nutritional support for patients with liver cancer. Enteral nutrition support, as a vital pattern of nutrition support, has gradually captivated attention in the perioperative application of liver cancer. In this article, the latest research progress in perioperative nutritional risk screening, the opportunity of enteral nutritional support, the patterns and preparations of enteral nutritional support were reviewed, aiming to provide theoretical basis for nutritional intervention in patients with liver cancer.

Key words: Carcinoma, hepatocelluar, Perioperative period, Enteral nutrition

Peiyue Chen, Yun Dong, Dawei Deng, Caifang Gong, Junyu Zhao, Chuan You. Research progress in perioperative nutritional risk screening and enteral nutritional support for liver cancer[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(04): 631-635.

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References 50

[1]	中国抗癌协会肝癌专业委员会. 中国肿瘤整合诊治指南-肝癌(2022精简版)[J]. 中国肿瘤临床, 2022, 49(17): 865-873. DOI: 10.12354/j.issn.1000-8179.2022.20220942.
[2]	唐小丽, 王海清, 杨洁, 等. 肝癌合并肝硬化患者围手术期目标营养管理临床实践[J/CD]. 肿瘤代谢与营养电子杂志, 2021, 8(4): 408-413.
[3]	Maki H, Hasegawa K. Advances in the surgical treatment of liver cancer[J]. Biosci Trends, 2022, 16(3): 178-188. DOI: 10.5582/bst.2022.01245.
[4]	Qiu J, Wang Y. Effect of accelerated rehabilitation combined with enteral nutrition on gastrointestinal function recovery after hepatectomy[J]. Support Care Cancer, 2022, 30(11): 8927-8933. DOI: 10.1007/s00520-022-07290-1.
[5]	顾娇娇, 张慧玲, 邹燕, 等. 基于简易营养评价精法的肝癌住院患者营养状况评估及影响因素分析[J]. 当代护士, 2023, 30(29): 112-116. DOI: 10.19792/j.cnki.1006-6411.2023.29.026.
[6]	Guo ZQ, Yu JM, Li W, et al. Survey and analysis of the nutritional status in hospitalized patients with malignant gastric tumors and its influence on the quality of life[J]. Support Care Cancer, 2020, 28(1): 373-380. DOI: 10.1007/s00520-019-04803-3.
[7]	Nobs SP, Zmora N, Elinav E. Nutrition regulates innate immunity in health and disease[J]. Annu Rev Nutr, 2020, 40: 189-219. DOI: 10.1146/annurev-nutr-120919-094440.
[8]	Plauth M, Bernal W, Dasarathy S, et al. ESPEN guideline on clinical nutrition in liver disease[J]. Clin Nutr, 2019, 38(2): 485-521. DOI: 10.1016/j.clnu.2018.12.022.
[9]	Wang L, Wang X, Wang X. The effectiveness of enteral nutrition for patients with primary liver cancer: a randomized controlled study protocol[J]. Medicine, 2021, 100(3): e23973. DOI: 10.1097/MD.0000000000023973.
[10]	李建芳, 李杰. 结合营养风险筛查的术前营养补充对原发性肝癌术后并发症的影响[J]. 肿瘤基础与临床, 2022, 35(3): 256-258. DOI: 10.3969/j.issn.1673-5412.2022.03.019.
[11]	陈春霞, 徐冠华, 崔志明. 营养评估在肝癌患者治疗中的应用研究进展[J]. 南京医科大学学报(自然科学版), 2022, 42(10): 1488-1494. DOI: 10.7655/NYDXBNS20221023.
[12]	Li F, Ren Y, Fan J, et al. The predictive value of the preoperative albumin-to-fibrinogen ratio for postoperative hospital length of stay in liver cancer patients[J]. Cancer Med, 2023, 12(20): 20321-20331. DOI: 10.1002/cam4.6606.
[13]	Wang J, Tan S, Gianotti L, et al. Evaluation and management of body composition changes in cancer patients[J]. Nutrition, 2023, 114: 112132. DOI: 10.1016/j.nut.2023.112132.
[14]	Pokharel N, Katwal G, Adhikari SK. Comparison of preoperative nutritional risk index and body mass index for predicting immediate postoperative outcomes following major gastrointestinal surgery: cohort-study[J]. Ann Med Surg, 2019, 48: 53-58. DOI: 10.1016/j.amsu.2019.10.011.
[15]	Weimann A, Braga M, Carli F, et al. ESPEN guideline: clinical nutrition in surgery[J]. Clin Nutr, 2017, 36(3): 623-650. DOI: 10.1016/j.clnu.2017.02.013.
[16]	蒋慧. 营养风险筛查2002、营养不良通用筛查工具和患者主观整体评估在住院肿瘤患者中的应用[J]. 河南医学研究, 2020, 29(2): 226-228. DOI: 10.3969/j.issn.1004-437X.2020.02.012.
[17]	陈大宇, 卞晓洁, 于冬悦, 等. 肝癌肝切除术患者两种营养风险筛查工具的适用比较[J]. 药学与临床研究, 2018, 26(2): 130-134. DOI: 10.13664/j.cnki.pcr.2018.02.014.
[18]	Silva DMD, Henz AC, Fernandes SA, et al. Nutritional diagnosis of patients with hepatocellular carcinoma: what is the best method?[J]. Nutr Hosp, 2019, 36(4): 884-889. DOI: 10.20960/nh.02542.
[19]	Huang TH, Hsieh CC, Kuo LM, et al. Malnutrition associated with an increased risk of postoperative complications following hepatectomy in patients with hepatocellular carcinoma[J]. HPB, 2019, 21(9): 1150-1155. DOI: 10.1016/j.hpb.2019.01.003.
[20]	Lobo DN, Gianotti L, Adiamah A, et al. Perioperative nutrition: recommendations from the ESPEN expert group[J]. Clin Nutr, 2020, 39(11): 3211-3227. DOI: 10.1016/j.clnu.2020.03.038.
[21]	夏伟芬, 张坤, 谭炜. 早期肠内营养支持对肝癌术后患者胃肠功能恢复和营养状态的影响[J]. 浙江医学, 2023, 45(9): 955-958. DOI: 10.12056/j.issn.1006-2785.2023.45.9.2022-3286.
[22]	Hellerman Itzhaki M, Singer P. Advances in medical nutrition therapy: parenteral nutrition[J]. Nutrients, 2020, 12(3): 717. DOI: 10.3390/nu12030717.
[23]	Yao H, Bian X, Mao L, et al. Preoperative enteral nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma: a strengthening the reporting of observational studies in epidemiology article[J]. Medicine, 2015, 94(46): e2006. DOI: 10.1097/MD.0000000000002006.
[24]	Weimann A, Braga M, Carli F, et al. ESPEN practical guideline: clinical nutrition in surgery[J]. Clin Nutr, 2021, 40(7): 4745-4761. DOI: 10.1016/j.clnu.2021.03.031.
[25]	Xiang Y, Zhang S, Cui Z, et al. Exploring the effect of microecological agents on postoperative immune function in patients undergoing liver cancer surgery: a systematic review and meta-analysis[J]. Ann Palliat Med, 2021, 10(11): 11615-11627. DOI: 10.21037/apm-21-2669.
[26]	李欢欢, 朱威丽, 戴诗婷, 等. 早期肠内营养支持对老年原发性肝癌患者TACE术后营养状态、肝功能及免疫功能的影响[J]. 航空航天医学杂志, 2020, 31(6): 750-751. DOI: 10.3969/j.issn.2095-1434.2020.06.064.
[27]	Xu Y, Wei FX. A retrospective study of enteral nutrition on immune and inflammatory factors after liver cancer surgery[J]. Medicine, 2021, 100(44): e27718. DOI: 10.1097/MD.0000000000027718.
[28]	Jiang Q, Xu T. Effect of early low-calorie enteral nutrition support in critically ill patients: a systematic review and meta-analysis[J]. Biomed Res Int, 2022, 2022: 7478373. DOI: 10.1155/2022/7478373.
[29]	Yan X, Liu L, Zhang Y, et al. Perioperative enteral nutrition improves postoperative recovery for patients with primary liver cancer: a randomized controlled clinical trial[J]. Nutr Cancer, 2021, 73(10): 1924-1932. DOI: 10.1080/01635581.2020.1814824.
[30]	Robledo-Valdez M, Cervantes-Pérez E, Cervantes-Guevara G, et al. Current concepts on preoperative nutritional support: how, when and why?[J]. Cir Cir, 2022, 90(4): 556-563. DOI: 10.24875/CIRU.20000893.
[31]	Ruiz-Margáin A, Román-Calleja BM, Moreno-Guillén P, et al. Nutritional therapy for hepatocellular carcinoma[J]. World J Gastrointest Oncol, 2021, 13(10): 1440-1452. DOI: 10.4251/wjgo.v13.i10.1440.
[32]	Cogo E, Elsayed M, Liang V, et al. Are supplemental branched-chain amino acids beneficial during the oncological peri-operative period: a systematic review and meta-analysis[J]. Integr Cancer Ther, 2021, 20: 1534735421997551. DOI: 10.1177/1534735421997551.
[33]	李地欢, 刘明, 江华. 《中国成年患者营养治疗通路指南》解读:外科空肠造口[J/CD]. 肿瘤代谢与营养电子杂志, 2022, 9(3): 293-297. DOI: 10.16689/j.cnki.cn11-9349/r.2022.03.005.
[34]	Fugazza A, Capogreco A, Cappello A, et al. Percutaneous endoscopic gastrostomy and jejunostomy: indications and techniques[J]. World J Gastrointest Endosc, 2022, 14(5): 250-266. DOI: 10.4253/wjge.v14.i5.250.
[35]	Wobith M, Weimann A. Postoperative nutrition management: who needs what?[J]. Visc Med, 2022, 38(5): 354-362. DOI: 10.1159/000526665.
[36]	吕俊玲, 夏路风, 胡咏川, 等. 肠内营养制剂基本特点及治疗中的药学监护[J]. 临床药物治疗杂志, 2020, 18(10): 76-79. DOI: 10.3969/j.issn.1672-3384.2020.10.017.
[37]	广东省药学会. 肠外肠内营养临床药学实践共识(2022年版)[J]. 今日药学, 2023, 33(6): 414-421. DOI: 10.12048/j.issn.1674-229X.2023.06.002.
[38]	Limketkai BN, Shah ND, Sheikh GN, et al. Classifying enteral nutrition: tailored for clinical practice[J]. Curr Gastroenterol Rep, 2019, 21(9): 47. DOI: 10.1007/s11894-019-0708-3.
[39]	张鸽文, 王志明. 肝脏手术病人围手术期营养支持[J]. 肠外与肠内营养, 2018, 25(5): 257-261. DOI: 10.16151/j.1007-810x.2018.05.001.
[40]	Shah ND, Barritt AS 4th. Nutrition as therapy in liver disease[J]. Clin Ther, 2022, 44(5): 682-696. DOI: 10.1016/j.clinthera.2022.04.012.
[41]	Wanden-Berghe C, Patino-Alonso MC, Galindo-Villardón P, et al. Complications associated with enteral nutrition: CAFANE study[J]. Nutrients, 2019, 11(9): 2041. DOI: 10.3390/nu11092041.
[42]	Hoffmann M, Schwarz CM, Fürst S, et al. Risks in management of enteral nutrition in intensive care units: a literature review and narrative synthesis[J]. Nutrients, 2020, 13(1): 82. DOI: 10.3390/nu13010082.
[43]	Whelan K, Schneider SM. Mechanisms, prevention, and management of diarrhea in enteral nutrition[J]. Curr Opin Gastroenterol, 2011, 27(2): 152-159. DOI: 10.1097/MOG.0b013e32834353cb.
[44]	Hammad A, Kaido T, Aliyev V, et al. Nutritional therapy in liver transplantation[J]. Nutrients, 2017, 9(10): 1126. DOI: 10.3390/nu9101126.
[45]	Elmahdi A, Eisa M, Omer E. Aspiration pneumonia in enteral feeding: a review on risks and prevention[J]. Nutr Clin Pract, 2023, 38(6): 1247-1252. DOI: 10.1002/ncp.11020.
[46]	Vadivelu N, Kodumudi G, Leffert LR, et al. Evolving therapeutic roles of nasogastric tubes: current concepts in clinical practice[J]. Adv Ther, 2023, 40(3): 828-843. DOI: 10.1007/s12325-022-02406-9.
[47]	Jia R, Zhao H, Yan X, et al. The effect of enteral nutrition nursing intervention on postoperative treatment of chronic critically ill patients: health prevention data analysis[J]. Prev Med, 2023, 174: 107635. DOI: 10.1016/j.ypmed.2023.107635.
[48]	Doley J. Enteral nutrition overview[J]. Nutrients, 2022, 14(11): 2180. DOI: 10.3390/nu14112180.
[49]	郑宇, 周冰倩, 龚妮. 肠内营养后高血糖的研究进展[J]. 中国普通外科杂志, 2023, 32(10): 1608-1616. DOI: 10.7659/j.issn.1005-6947.2023.10.020.
[50]	Ley D, Austin K, Wilson KA, et al. Tutorial on adult enteral tube feeding: indications, placement, removal, complications, and ethics[J]. JPEN J Parenter Enteral Nutr, 2023, 47(5): 677-685. DOI: 10.1002/jpen.2510.

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