P51 NUTRITIONAL DEFICIENCY POST OESOPHAGO-GASTRIC SURGERY IN CANCER PATIENTS

• Published in: Diseases of the esophagus 2019-11, Vol.32 (Supplement_2)
• Main Authors: Pushpa, Veeralakshmanan Ji Chung Tham, Himanshu, Wadhawan, Amy, Wright, Marilyn, Bolter, Richard, Berrisford, Lee, M Humphreys, Tim, Wheatley, Grant, Sanders, Arun, Ariyarathenam
• Format: Article
• Language: English
• ISSN: 1442-2050; 1442-2050
• DOI: 10.1093/dote/doz092.51

Abstract Aim Postoperative nutritional status is an important prognostic factor in patients undergoing oesophagectomy or gastrectomy for malignant tumours. The deterioration in nutritional status post oesophagectomy is seen more profoundly after 6 months of surgery [1]. In our unit, we successfully implemented Allied Health Professionals (AHP) led clinics consisting of cancer nurse specialist and specialist dietician to conduct routine follow-up for 5 year duration post oesophago-gastric surgery to help identify and manage nutritional deficiencies. Background & Methods AHP led outpatient clinic was established in February 2017. Between February 2017 and February 2018, all patients who were eligible and who attended the AHP clinic at our tertiary unit were included in the study. All patients who attended the clinic, had micronutrient screening in particular ferritin, folate, vitamin B12 and vitamin D. Patients were screened for exocrine pancreatic insufficiency (EPI) through series of questions related to symptoms of EPI including steatorrhea, flatulence, loose stools and urgency to defecate. All patients included in the study were started on A-Z multivitamin tablets from their first visit. Patients reporting symptoms indicative of EPI were started on Creon. Patients found deficient in any micronutrients were invited for a follow-up measurement of the respective deficiency. Results A total of 52 patients were included in the study period with a median follow-up of 17 months post oesophago-gastric cancer surgery. Proportion of patients with deficiency in ferritin, folate, vitamin B12 and vitamin D were 51.92%, 11.54%, 7.69% and 42.31% respectively. Proportion of patients identified with symptoms indicative of EPI was 36.54%. At re-test follow-up, 64.71% patient noticed settlement of symptoms of EPI and 85.91% of patients improved their ferritin levels at retest. Folate, Vitamin B12 and D levels significantly improved post initial AHP follow-up (significance level p