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Nutritional Consequences of Surgical Resection of the Gastrointestinal Tract for Cancer¹

Division of Surgical Oncology and Cancer Center, Medical College of Virginia (Virginia Commonwealth University), Richmond, Virginia 23298

The nutritional sequelae of major resection of the "hollow organs" of the gastrointestinal tract for cancer are reviewed. Radical surgery of the head and neck region may lead to significant nutritional problems due to the mechanical effects of surgery that limit normal methods for nutritional intake, but these problems can be overcome by tube feeding. Resection of the thoracic esophagus or stomach for cancer may produce varied forms of malabsorption, particularly of ingested fat, but the reduction of caloric intake that often will accompany these procedures plays the primary role in each instance where malnutrition is produced by the operation. These nutritional difficulties are corrected by assuring adequate caloric intake and reducing the symptoms that inhibit this. Small bowel resection rarely produces nutritional problems unless the resection is massive, a situation wherein malabsorption becomes a major problem in nutritional management. Fortunately, massive small bowel resection is rarely indicated for the treatment of cancer. Radical colon surgery of any extent is well tolerated from the nutritional standpoint. An understanding of the causes of malnutrition in patients undergoing surgical resection of the gastrointestinal tract for cancer should lead to effective management of any problems that do occur.

¹ Presented at the Conference on Nutrition and Cancer Therapy, November 29 to December 1, 1976, Key Biscayne, Fla.

² American Cancer Society Professor of Clinical Oncology.