An assessment of nutritional depletion following major colonic surgery

This study was undertaken to determine the changes in basic nutritional indices associated with major colonic surgery accompanied by periods of semi-starvation. Changes in weight, serum albumin, nitrogen balance, and maximum exercise capacity were studied. Weight loss was 5.5 +/- 1 per cent, serum albumin decreased 0.20 +/- 0.15 gm per cent. Nitrogen loss was 5.9 +/- 0.9 gm per day and maximum exercise capacity decreased by 13.5 +/- 1.8 per cent. Nitrogen balance improved when amino acids were substituted for glucose as the maintenance regimen, but no corresponding improvement in exercise performance could be demonstrated. It is concluded that major colonic surgery associated with moderate periods of semi-starvation is associated with an average nitrogen loss of 5.9 +/- 0.9 gm per day and a 13.5 +/- 1.8 per cent loss in maximum exercise capacity or effective muscle mass.