[Morbidity, mortality, and total parenteral nutrition in esophageal and gastric surgery for benign pathology]

We performed a retrospective study in patients undergoing mayor elective surgery of the upper gastrointestinal tract for benign disease receiving perioperative total parenteral nutrition (TPN). We analyzed the clinical charts from patients admitted to the Hospital de Especialidades del Centro Médico de Occidente for this purpose from January 1983 to March 1987, selecting those who had clinical or laboratory criteria of severe malnutrition. They were divided in two groups depending on whether TPN was being indicated as preoperative preparation and continued through the postoperative period (GE = 32 patients), or initiated after surgery (GC = 13 patients). The results show statistical differences in morbidity (GC = 100%, GE = 27%), mortality (GC = 30%, GE = none), need of reoperation (GC = 30%, GE = none) and costs (higher in GE). Complications related to TPN in GC were 23% and 15% in GE, and there were no deaths related on either group. Based on our results, we consider the need of a good selection of candidates to receive preoperative and postoperative TPN when undergoing major elective surgery, which should be continued until they are able to cover their nutritional requirements by oral or enteral route. This applies whenever there is sufficient clinical and laboratory data of severe malnutrition.