Nutritional Assessment in Digestive Carcinology Surgery

Malnutrition is a major public health concern, particularly among patients with digestive cancers, where it contributes to higher rates of postoperative complications, delayed healing, and increased morbidity. This retrospective study, conducted over six months from January to June 2024 in the visceral surgery department of Ibn Tofail Hospital, CHU Mohammed VI in Marrakech, aimed to evaluate the perioperative nutritional management of patients undergoing digestive oncologic surgery and assess adherence to current guidelines. A total of 31 patients were included, with a mean age of 59.6 years (range 37–89) and a sex ratio of 1.07. The most frequent cancers were gastric and colorectal (38.7% each), followed by pancreatic-duodenal cancers (22.6%). Malnutrition (GN4) was identified in 61.3% of patients, based on recent weight loss (61.3%), low BMI (25.8%), and hypoalbuminemia (12.9%). Only 25.8% received preoperative nutritional support—Oliclinomel (12.9%), albumin (9.7%), or oral supplements (6.4%)—while 67.7% received postoperative nutrition. Malnutrition was significantly associated with older age (p=0.01) and persistent digestive symptoms (p=0.003). Additionally, 25.8% had postoperative complications, and 12.9% required ICU admission, with no reported deaths. These findings highlight a high prevalence of preoperative malnutrition and inconsistent nutritional support, particularly in the use of recommended supplements such as immunonutriments and trace elements. Improving preoperative nutritional assessment, especially during anesthesia consultations, is essential for optimizing postoperative outcomes in this vulnerable population.