Feeding tube placement during cytoreductive surgery and heated intraperitoneal chemotherapy does not improve postoperative nutrition and is associated with longer length of stay and higher readmission rates

J Surg Res. 2016 Jan;200(1):158-63. doi: 10.1016/j.jss.2015.08.003. Epub 2015 Aug 13.


Background: Patients with colorectal cancer and peritoneal carcinomatosis (CRC/PC) may benefit from cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC). Nutritional support is frequently required for patients after CRS/HIPEC. It remains unclear if placement of feeding access is of benefit in regard to improving postoperative nutrition in this patient population.

Materials and methods: Patients with CRC/PC who underwent complete cytoreduction were evaluated. Preoperative and postoperative nutritional data and discharge outcomes were retrospectively recorded. The presence of a feeding tube and PCI scores were recorded by review of operative notes. Readmission rates were calculated for patients at 30 d and 60 d after discharge from hospital.

Results: Forty-one patients underwent CRS/HIPEC, 25 had feeding tube placement at the time of surgery. Weight loss was common after HIPEC as 38 of 41 patients demonstrated weight loss. The mean weight loss was 7.6%. total parenteral nutrition was required at discharge in four patients (7.9%); three of these patients had feeding access placed. There was no difference in the degree of weight loss between groups (7.1 ± 3.7% no tube versus 7.9 ± 5.8% patients with tube; P = 0.608). The mean decrease in albumin was 12.7% but was not significantly different in patients with feeding access and those without (10.0% versus 14.75%; P = 0.773). Sixty-day readmission rates were higher in patients with feeding tubes (36% compared with 0%, P < 0.01).

Conclusions: Significant nutritional loss is common after CRS/HIPEC for patients with CRC/PC. Feeding tube placement does not prevent this and appears to be related to higher readmission rates and longer length of stay.

Keywords: Carcinomatosis; Cytoreduction; Feeding tube; HIPEC; Nutrition.

Publication types

  • Evaluation Study

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma / secondary*
  • Carcinoma / therapy
  • Chemotherapy, Cancer, Regional Perfusion*
  • Colorectal Neoplasms / pathology*
  • Combined Modality Therapy
  • Cytoreduction Surgical Procedures*
  • Enteral Nutrition / adverse effects
  • Enteral Nutrition / methods*
  • Humans
  • Hyperthermia, Induced*
  • Intubation, Gastrointestinal
  • Length of Stay / statistics & numerical data
  • Mitomycin / administration & dosage
  • Nutritional Status
  • Organoplatinum Compounds / administration & dosage
  • Oxaliplatin
  • Patient Readmission / statistics & numerical data
  • Peritoneal Neoplasms / secondary*
  • Peritoneal Neoplasms / therapy
  • Postoperative Period
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss


  • Antineoplastic Agents
  • Organoplatinum Compounds
  • Oxaliplatin
  • Mitomycin