Cancer patients can recover faster from surgery – and potentially save the NHS millions – if they are given liquid food directly into the intestine, say researchers who are presenting at the National Cancer Research Institute Conference on Monday.
Patients with cancers of the oesophagus, stomach and pancreas have been traditionally fasted or are nil by mouth, for up to 10 days after gastrointestinal operations, as surgeons have long thought that nutrition after surgery may be detrimental to patients’ recovery.
But a clinical trial funded by a grant from the Health Foundation, and led by Cardiff University and the University Hospital of Wales has found that if patients are give nutrition directly into the intestine – through a feeding tube – they recover around three days faster than if they were fasted and only hydrated with fluids through a drip*.
Patients also developed fewer major complications following their surgery.
The trial of 121 patients looked at whether nutrition straight after surgery had any effect on the speed of recovery compared to eating nothing.
The researchers now believe that if liquid food is given after all major abdominal and thoracic surgery it could save the NHS millions of pounds.
Dr Rachael Barlow, lead investigator on the trial at Cardiff University and the University Hospital of Wales, said: “In our trial we turned the traditional thinking to starve patients after major gastrointestinal surgery on its head and have found huge benefits. The striking find that nutrients straight after surgery meant patients recovered quicker and tended to have fewer complications has major implications for the NHS.
“Importantly patients who were given the nutrition were more likely to be healthier and have a better quality of life in the months after surgery. And may result in a saving of millions of pounds and could mean fewer bed shortages in hospitals.
“A day in an NHS general or surgical ward costs up to £400 and in an intensive care unit it can cost up to £1200 or more. In this economic climate of financial deficits, finding new ways of improving care is important for NHS managers.
“The next step is to find out if we can adopt the same practice in other types of surgery and we are hoping to run more clinical trials in this area.”
Professor Sir Kenneth Calman, chair of the NCRI, said: “This result shows that a small change in follow up care after operations for oesophagus, stomach and pancreas cancer could benefit patients and have huge cost saving implications for the NHS. We look forward to seeing the results of further clinical trials to see if the same technique of food after surgery can be applied to patients who have had operations for other types of cancers.”
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References
Barlow R et al, Randomised controlled trial of Early Enteral Nutrition (EEN) versus Conventional Management (CON) in patients undergoing major resection for upper gastrointestinal cancer. NCRI conference 2009
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*Patients would usually be on an IV drip with water and saline
Cardiff and Vale University Local Health Board
Cardiff and Vale University Health Board is one of the largest in the UK, providing health services for over 500,000 people living in Cardiff and the Vale of Glamorgan.
We also serve a wider population of 2.5 million people across South and Mid Wales for specialties such as paediatric intensive care, specialist children’s services, renal services, cardiac services, neurology, bone marrow transplantation and medical genetics.
We provide healthcare in people’s own homes, community clinics, and hospitals, for outpatient, inpatient and emergency care. We manage nine hospitals and seventeen health centres, and also provide services in health centres run by our NHS partner organisations both within Cardiff and the Vale and beyond, in Caerphilly and Merthyr for example.
We are also responsible for the delivery of NHS primary care services in Cardiff and the Vale of Glamorgan, including general practitioners, community pharmacists, dentists and optometrists.
Cardiff and Vale University Health Board’s nine hospitals are; Barry Hospital, Cardiff Royal Infirmary West Wing, Children’s Hospital for Wales, University Hospital Llandough, Rookwood Hospital, St. David’s Hospital, University Dental Hospital, University Hospital of Wales, and Whitchurch Hospital.
We are a teaching trust with close links to Cardiff University. The University boasts a high profile teaching, research and development role within the UK and abroad. Together we are training the next generation of medical professionals.
In 2009 – 2010 the Trust’s total income was £653 million and we employed over 14,000 staff. The new University Health Board’s income will be approximately £940 million.
For more information, visit our website www.cardiffandvale.wales.nhs.uk
Cardiff University
Cardiff University is recognised in independent government assessments as one of Britain’s leading teaching and research universities and is a member of the Russell Group of the UK’s most research intensive universities.
Among its academic staff are two Nobel Laureates, including the winner of the 2007 Nobel Prize for Medicine, Professor Sir Martin Evans.
Founded by Royal Charter in 1883, today the University combines impressive modern facilities and a dynamic approach to teaching and research. The University’s breadth of expertise in research and research-led teaching encompasses: the humanities; the natural, physical, health, life and social sciences; engineering and technology; preparation for a wide range of professions; and a longstanding commitment to lifelong learning.
Visit the University website at: www.cardiff.ac.uk
