Gastric cancer remains a significant health challenge with substantial mortality rates worldwide. Surgery is often the mainstay of treatment for gastric cancer, but it comes with its own risks, including the development of postoperative fistulas. A recent study published in “Chirurgia (Bucharest, Romania: 1990)” has shed new light on the impact of nutritional status and disease stage on the incidence of postoperative fistulas in patients undergoing surgery for gastric cancer. This article delves into the nuances of the findings and underscores the imperative of nutritional intervention in preoperative care.

In the realm of gastric cancer treatment, the surgical intervention is a critical threshold that separates potential recovery from ongoing morbidity. However, one of the most dreaded complications post-surgery is the development of postoperative fistulas. A team of researchers led by Virgiliu M. Prunoiu aimed to investigate the intersecting factors that contribute to this complication.

The study, “The Importance of the Nutritional Factor and the Stage of the Disease in Postoperative Fistula in Patients with Gastric Cancer” published in the March-April 2019 issue of Chirurgia, presented a retrospective analysis of patients who had undergone surgery for gastric cancer. The findings, now compiled in an extensive review, illuminate the pivotal role of the nutritional factor and the stage of the disease in the postoperative trajectory of these patients.

Methodology and Demographics

The researchers conducted a retrospective analysis examining the medical records of patients diagnosed with gastric cancer who underwent surgical procedures. The study analyzed variables including age, gender, preoperative nutritional status, the method of nutritional support, the stage of the disease, surgical technique, and the development of postoperative fistulas.

Key Findings

One of the paramount results from the study highlighted that patients with a compromised nutritional status preoperatively exhibited a heightened risk of developing postoperative fistulas. Specifically, individuals presenting with weight loss and those requiring parenteral nutrition before surgery were at increased odds of encountering this complication.

The study further revealed that the risk did not distribute evenly across all patients but was more pronounced in those with advanced stages of gastric cancer. This key insight placed a spotlight on the stage of the disease as an influential determinant of postoperative outcome variability.


The convergence of findings from this study draws attention to the influential role of nutritional status in mitigating postoperative complications such as fistulas in patients with gastric cancer. Consequently, researchers concluded that thorough preoperative nutritional assessment and intervention should be fundamental components of gastric cancer management.

Furthermore, emphasizing the need for personalized care, the study underscored the criticality of considering the stage of the disease in preoperative planning and post-operative management, suggesting that a one-size-fits-all approach might be inadequate to cope with the diverse range of patient circumstances.

Implications and Recommendations

Given the persuasive evidence presented in this study, medical practitioners are encouraged to prioritize nutritional evaluation and supplementation in the preoperative phase for gastric cancer patients. This necessitates a multidisciplinary approach to patient care, integrating the expertise of oncologists, surgeons, nutritionists, and other specialists.

In addition, these findings call for a more stratified management protocol that accounts for the disease stage, perhaps suggesting more aggressive nutritional support or altered surgical strategies for patients in advanced stages of gastric cancer.

Closing Remarks

The research by Prunoiu et al. paves the way for a deeper understanding of the factors influencing postoperative outcomes in gastric cancer surgery. It is clear that nutritional care must not be overlooked and warrants as much meticulous attention as the surgical procedure itself.

The full research article, including more granular data and methodologies, can be found in the journal “Chirurgia (Bucharest, Romania: 1990),” volume 114, issue 2, on pages 259-267, with the DOI: 10.21614/chirurgia.114.2.259.


1. Prunoiu VM, Marincas AM, Pantis C, Bene A, Bratucu E, Ionescu S, Grigorescu A. The Importance of the Nutritional Factor and the Stage of the Disease in Postoperative Fistula in Patients with Gastric Cancer. Chirurgia (Bucharest, Romania: 1990). 2019 Mar-Apr;114(2):259-267. DOI: 10.21614/chirurgia.114.2.259.
2. Ailliet M, et al. Preoperative Nutritional Status and Postoperative Complication Risk in Surgeons. Journal of Surgical Oncology. 2018.
3. Buzby GP, et al. Perioperative Total Parenteral Nutrition in Surgical Patients. The New England Journal of Medicine. 1980.
4. Weimann A, et al. ESPEN Guideline: Clinical Nutrition in Surgery. Clinical Nutrition. 2017.
5. Ryan AM, et al. The Role of Nutritional Support in the Physical and Functional Recovery of Critically Ill Patients: a Narrative Review. Critical Care. 2016.


1. Gastric Cancer Surgery
2. Postoperative Fistula Risk
3. Preoperative Nutritional Status
4. Gastric Cancer Treatment Complications
5. Surgical Outcomes in Gastric Cancer