The importance of nutritional prehabilitation in elective colorectal surgery for morbidity, mortality, and length of hospital stay: A single center study

Abstract Background The nutritional status of the patient before undergoing surgery for colorectal cancer and its influence on the subsequent recovery has been the subject of a number of studies with ambiguous results. There are articles in the literature which emphasize the role of preoperative nutritional prehabilitation in other malignancies. Considering this we assumed a positive effect of nutritional preoperative prehabilitation on reducing the number of postoperative complications in patients operated for colorectal cancer. This study aims to confirm this hypothesis. Methods The study was designed as a prospective-retrospective study of a group of patients undergoing elective surgery in the period May 2021—April 2022. The aim of the study was to demonstrate a decrease in postoperative morbidity, mortality, and a reduction in the length of hospital stay as a result of preoperatively applied systematic nutritional prehabilitation of the patients compared to the control group from 2015, when systematic nutritional prehabilitation had not yet been implemented. In the examined group, we evaluated the MUST score and laboratory nutritional parameters. If a risk of severe malnutrition has been detected, the patient underwent preoperative nutritional support. After the surgery morbidity, mortality, and length of hospital stay in both groups were evaluated and compared to each other. Results The only significantly improved parameter in the examined group was the shortened length of hospital stay, the other results did not show statistical significance, only partial differences between the groups in severe morbidity were detected. Conclusion Although our study only demonstrated a reduction in the length of hospital stay we strongly support the benefits of the targeted nutritional prehabilitation of patients with colorectal cancer who are at risk of malnutrition. We propose to evaluate the nutritional status based on MUST score, and when the risk of malnutrition is detected (MUST 2 or more), sipping with predefined oral nutritional supplements should be implemented.