Best evidence summary for nutritional management of cancer patients with chyle leaks following surgery
BackgroundChyle leaks (CL) is a significant postoperative complication following lymph node dissection in cancer patients. Persistent CK is related to a series of adverse outcomes. Nutritional management is considered an effectively strategy that treat CL. However, the existing evidence on nutrition...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2024.1478190/full |
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| author | Jie Zhou Wentao Huang Ya Hu Fen Liu Man Xu Xiaoping Chen Mingzhu Xin Huiming Lu Xia Zheng |
| author_facet | Jie Zhou Wentao Huang Ya Hu Fen Liu Man Xu Xiaoping Chen Mingzhu Xin Huiming Lu Xia Zheng |
| author_sort | Jie Zhou |
| collection | DOAJ |
| description | BackgroundChyle leaks (CL) is a significant postoperative complication following lymph node dissection in cancer patients. Persistent CK is related to a series of adverse outcomes. Nutritional management is considered an effectively strategy that treat CL. However, the existing evidence on nutritional management for this patient cohort fails to provide actionable clinical guidance.AimThis study was aimed to establish an evidence-based framework for nutritional management, offering reliable basis for clinical nursing practice.MethodsUtilizing the “6S” mode, we conducted a systematic search of UpToDate, BMJ, Best Practice, Cochrane Library, Joanna Briggs Institute (JBI) Center for Evidence-Based Health Care Database, National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses' Association of Ontario (RNAO), World Health Organization, Medlive, American Society for Parenteral and Enteral Nutrition (ASPEN), European Society for Clinical Nutrition and Metabolism (ESPEN), Web of Science, PubMed, Embase, CINAHL, China Biology Medicine (CBM), and China National Knowledge Infrastructure (CNKI) for all evidence on the nutritional management of postoperative coeliac leakage in cancer patients. This search included guidelines, evidence summaries, expert consensus, clinical decision-making, recommended practices, systematic evaluations or Meta-analyses, randomized controlled trials (RCTs), and class experiments. The search timeframe was from the library's establishment to June 2024. Quality assessment of the literature was completed independently by two researchers with professional evidence-based training and expert advice, and evidence was extracted and summarized for those that met the quality criteria.ResultsA total of 13 articles were included in the analysis, comprising two expert consensus, one guideline, one class of experimental studies, seven systematic evaluations, and two clinical decisions. We summarized 22 pieces of evidence across five categories: nutritional screening, assessment, and monitoring, timing of nutritional therapy, methods and approaches to nutritional therapy, nutrient requirements, and dietary modification strategies.ConclusionThis study presents key evidence for nutritional management in cancer patients with CL post-surgery, emphasizing nutritional screening, assessment, timing and methods of therapy, and dietary adjustment strategies. It emphasized the necessity of thorough screening tools for the assessment of nutritional condition, and the benefits of early enteral feeding. A multidisciplinary team approach is vital for conducting personalized dietary, while sustained nutritional support, dietary fat restrictions, and medium-chain triglycerides enhance nutrient absorption. Consistent monitoring of chylous fluid output and timely dietary adjustments are crucial for improving patient outcomes and recovery.Systematic review registrationhttp://ebn.nursing.fudan.edu.cn/registerResources, identifier ES20244732. |
| format | Article |
| id | doaj-art-f8d15a5b48dd4735800452ef0a319ad8 |
| institution | Kabale University |
| issn | 2296-861X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Nutrition |
| spelling | doaj-art-f8d15a5b48dd4735800452ef0a319ad82025-01-08T15:34:22ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-01-011110.3389/fnut.2024.14781901478190Best evidence summary for nutritional management of cancer patients with chyle leaks following surgeryJie Zhou0Wentao Huang1Ya Hu2Fen Liu3Man Xu4Xiaoping Chen5Mingzhu Xin6Huiming Lu7Xia Zheng8Department of Urinary Surgery, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaPostanesthsia Care Unit, Department of Anesthesiology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Urinary Surgery, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Urinary Surgery, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Urinary Surgery, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Urinary Surgery, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Nursing, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Urinary Surgery, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Urinary Surgery, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaBackgroundChyle leaks (CL) is a significant postoperative complication following lymph node dissection in cancer patients. Persistent CK is related to a series of adverse outcomes. Nutritional management is considered an effectively strategy that treat CL. However, the existing evidence on nutritional management for this patient cohort fails to provide actionable clinical guidance.AimThis study was aimed to establish an evidence-based framework for nutritional management, offering reliable basis for clinical nursing practice.MethodsUtilizing the “6S” mode, we conducted a systematic search of UpToDate, BMJ, Best Practice, Cochrane Library, Joanna Briggs Institute (JBI) Center for Evidence-Based Health Care Database, National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses' Association of Ontario (RNAO), World Health Organization, Medlive, American Society for Parenteral and Enteral Nutrition (ASPEN), European Society for Clinical Nutrition and Metabolism (ESPEN), Web of Science, PubMed, Embase, CINAHL, China Biology Medicine (CBM), and China National Knowledge Infrastructure (CNKI) for all evidence on the nutritional management of postoperative coeliac leakage in cancer patients. This search included guidelines, evidence summaries, expert consensus, clinical decision-making, recommended practices, systematic evaluations or Meta-analyses, randomized controlled trials (RCTs), and class experiments. The search timeframe was from the library's establishment to June 2024. Quality assessment of the literature was completed independently by two researchers with professional evidence-based training and expert advice, and evidence was extracted and summarized for those that met the quality criteria.ResultsA total of 13 articles were included in the analysis, comprising two expert consensus, one guideline, one class of experimental studies, seven systematic evaluations, and two clinical decisions. We summarized 22 pieces of evidence across five categories: nutritional screening, assessment, and monitoring, timing of nutritional therapy, methods and approaches to nutritional therapy, nutrient requirements, and dietary modification strategies.ConclusionThis study presents key evidence for nutritional management in cancer patients with CL post-surgery, emphasizing nutritional screening, assessment, timing and methods of therapy, and dietary adjustment strategies. It emphasized the necessity of thorough screening tools for the assessment of nutritional condition, and the benefits of early enteral feeding. A multidisciplinary team approach is vital for conducting personalized dietary, while sustained nutritional support, dietary fat restrictions, and medium-chain triglycerides enhance nutrient absorption. Consistent monitoring of chylous fluid output and timely dietary adjustments are crucial for improving patient outcomes and recovery.Systematic review registrationhttp://ebn.nursing.fudan.edu.cn/registerResources, identifier ES20244732.https://www.frontiersin.org/articles/10.3389/fnut.2024.1478190/fullchyle leakslymph node dissectioncancernutritional managementbest evidencereview |
| spellingShingle | Jie Zhou Wentao Huang Ya Hu Fen Liu Man Xu Xiaoping Chen Mingzhu Xin Huiming Lu Xia Zheng Best evidence summary for nutritional management of cancer patients with chyle leaks following surgery Frontiers in Nutrition chyle leaks lymph node dissection cancer nutritional management best evidence review |
| title | Best evidence summary for nutritional management of cancer patients with chyle leaks following surgery |
| title_full | Best evidence summary for nutritional management of cancer patients with chyle leaks following surgery |
| title_fullStr | Best evidence summary for nutritional management of cancer patients with chyle leaks following surgery |
| title_full_unstemmed | Best evidence summary for nutritional management of cancer patients with chyle leaks following surgery |
| title_short | Best evidence summary for nutritional management of cancer patients with chyle leaks following surgery |
| title_sort | best evidence summary for nutritional management of cancer patients with chyle leaks following surgery |
| topic | chyle leaks lymph node dissection cancer nutritional management best evidence review |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2024.1478190/full |
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