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1. Robotic liver resection versus percutaneous ablation for early hcc: Short-and long-term results

Author

Magistri, P, Catellani, B, Frassoni, S, Guidetti, C, Olivieri, T, Assirati, G, Caporali, C, Pecchi, A, Serra, V, Ballarin, R, Guerrini, G, Bagnardi, V, Di Sandro, S, Di Benedetto, F, Magistri P., Catellani B., Frassoni S., Guidetti C., Olivieri T., Assirati G., Caporali C., Pecchi A., Serra V., Ballarin R., Guerrini G. P., Bagnardi V., Di Sandro S., Di Benedetto F., Magistri, P, Catellani, B, Frassoni, S, Guidetti, C, Olivieri, T, Assirati, G, Caporali, C, Pecchi, A, Serra, V, Ballarin, R, Guerrini, G, Bagnardi, V, Di Sandro, S, Di Benedetto, F, Magistri P., Catellani B., Frassoni S., Guidetti C., Olivieri T., Assirati G., Caporali C., Pecchi A., Serra V., Ballarin R., Guerrini G. P., Bagnardi V., Di Sandro S., and Di Benedetto F.

Abstract

Background: The correct approach for early hepatocellular carcinoma (HCC) is debatable, since multiple options are currently available. Percutaneous ablation (PA) is associated in some series to reduced morbidity compared to liver resection (LR); therefore, minimally invasive surgery may play a significant role in this setting. Methods: All consecutive patients treated by robotic liver resection (RLR) or PA between January 2014 and October 2019 for a newly diagnosed single HCC, less than 3 cm in size (very early/early stages according to the Barcelona Clinic Liver Cancer (BCLC)) on chronic liver disease or liver cirrhosis, were enrolled in this retrospective study. The aim of this study was to compare short-and long-term outcomes to define the best approach in this specific cohort. Results: 60 patients fulfilled the inclusion criteria: 24 RLR and 36 PA. The two populations were homogeneous in terms of baseline characteristics. There were no statistically significant differences regarding the incidence of postoperative morbidity (RLR 38% vs. PA 19%, p = 0.15). The cumulative incidence of recurrence (CIR) was significantly higher in patients who underwent PA, with the one, two, and three years of CIR being 42%, 69%, and 73% in the PA group and 17%, 27%, and 27% in the RLR group, respectively. Conclusions: RLR provides a significantly higher potential of cure and tumor-related free survival in cases of newly diagnosed single HCCs smaller than 3 cm. Therefore, it can be considered as a first-line approach for the treatment of patients with those characteristics in high-volume centers with extensive experience in the field of hepatobiliary surgery and minimally invasive approaches.

Published
2020

2. Under-dilated TIPS Associate With Efficacy and Reduced Encephalopathy in a Prospective, Non-randomized Study of Patients With Cirrhosis

Author

Schepis, F, Vizzutti, F, Garcia-Tsao, G, Marzocchi, G, Rega, L, De Maria, N, Di Maira, T, Gitto, S, Caporali, C, Colopi, S, De Santis, M, Arena, U, Rampoldi, A, Airoldi, A, Cannavale, A, Fanelli, F, Mosconi, C, Renzulli, M, Agazzi, R, Nani, R, Quaretti, P, Fiorina, I, Moramarco, L, Miraglia, R, Luca, A, Bruno, R, Fagiuoli, S, Golfieri, R, Torricelli, P, Di Benedetto, F, Belli, L, Banchelli, F, Laffi, G, Marra, F, Villa, E, Schepis F., Vizzutti F., Garcia-Tsao G., Marzocchi G., Rega L., De Maria N., Di Maira T., Gitto S., Caporali C., Colopi S., De Santis M., Arena U., Rampoldi A., Airoldi A., Cannavale A., Fanelli F., Mosconi C., Renzulli M., Agazzi R., Nani R., Quaretti P., Fiorina I., Moramarco L., Miraglia R., Luca A., Bruno R., Fagiuoli S., Golfieri R., Torricelli P., Di Benedetto F., Belli L. S., Banchelli F., Laffi G., Marra F., Villa E., Schepis, F, Vizzutti, F, Garcia-Tsao, G, Marzocchi, G, Rega, L, De Maria, N, Di Maira, T, Gitto, S, Caporali, C, Colopi, S, De Santis, M, Arena, U, Rampoldi, A, Airoldi, A, Cannavale, A, Fanelli, F, Mosconi, C, Renzulli, M, Agazzi, R, Nani, R, Quaretti, P, Fiorina, I, Moramarco, L, Miraglia, R, Luca, A, Bruno, R, Fagiuoli, S, Golfieri, R, Torricelli, P, Di Benedetto, F, Belli, L, Banchelli, F, Laffi, G, Marra, F, Villa, E, Schepis F., Vizzutti F., Garcia-Tsao G., Marzocchi G., Rega L., De Maria N., Di Maira T., Gitto S., Caporali C., Colopi S., De Santis M., Arena U., Rampoldi A., Airoldi A., Cannavale A., Fanelli F., Mosconi C., Renzulli M., Agazzi R., Nani R., Quaretti P., Fiorina I., Moramarco L., Miraglia R., Luca A., Bruno R., Fagiuoli S., Golfieri R., Torricelli P., Di Benedetto F., Belli L. S., Banchelli F., Laffi G., Marra F., and Villa E.

Abstract

Background & Aims: Portosystemic encephalopathy (PSE) is a major complication of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement. Most devices are self-expandable polytetrafluoroethylene-covered stent grafts (PTFE-SGs) that are dilated to their nominal diameter (8 or 10 mm). We investigated whether PTFE-SGs dilated to a smaller caliber (under-dilated TIPS) reduce PSE yet maintain clinical and hemodynamic efficacy. We also studied whether under-dilated TIPS self-expand to nominal diameter over time. Methods: We performed a prospective, non-randomized study of 42 unselected patients with cirrhosis who received under-dilated TIPS (7 and 6 mm) and 53 patients who received PTFE-SGs of 8 mm or more (controls) at referral centers in Italy. After completion of this study, dilation to 6 mm became the standard and 47 patients were included in a validation study. All patients were followed for 6 months; Doppler ultrasonography was performed 2 weeks and 3 months after TIPS placement and every 6 months thereafter. Stability of PTFE-SG diameter was evaluated by computed tomography analysis of 226 patients with cirrhosis whose stent grafts increased to 6, 7, 8, 9, or 10 mm. The primary outcomes were incidence of at least 1 episode of PSE grade 2 or higher during follow up, incidence of recurrent variceal hemorrhage or ascites, incidence of shunt dysfunction requiring TIPS recanalization, and reduction in porto-caval pressure gradient. Results: PSE developed in a significantly lower proportion of patients with under-dilated TIPS (27%) than controls (54%) during the first year after the procedure (P =.015), but the proportions of patients with recurrent variceal hemorrhage or ascites did not differ significantly between groups. No TIPS occlusions were observed. These results were confirmed in the validation cohort. In an analysis of self-expansion of stent grafts, during a mean follow-up period of 252 days after placement, none of the PTFE-SGs self-expanded to t

Published
2018

3. Parenteral and enteral feeding in hospitals in Italy: a national survey

Author

Braga, M, Bozzetti, F, Dionigi, P, Radrizzani, D, Iapichino, G, Salis, C, Scroccaro, G, Gelio, S, Messori, A, Tognoni, G, Zanello, M, Ferrara, F, Corti, A, Fanchini, P, Vernero, S, Congedo, R, Decicco, M, Morelli, M, Carrata, R, Laddaga, L, Lattarulo, M, Marchesi, G, Sequenza, S, Stivala, B, Lanzone, L, Sozzi, P, Raitano, A, Fiacchi, M, Pierangeli, A, Russito, G, Caporali, C, Bittasi, P, Sanna, P, Savona, G, Usai, C, Accogli, P, Selli, L, Pusceddu, P, Iasiello, G, Fazio, S, Badoino, C, Burlon, N, Lombardi, M, Bertana, P, Bartazzi, D, Paolucci, R, Tella, G, Callegari, R, Toffoletto, F, Torreggiani, L, Campo, S, Micheletti, I, Lidestri, G, Zanin, P, Giuliano, G, Chioldi, G, Perlasca, F, Grande, W, Pincelli, D, Paccagnella, A, Francesconi, R, Domeniconi, D, Bertotti, G, Campi, A, Vivarelli, R, Donati, D, Sibilla, C, Cervi, R, Vannucci, A, Tonelli, F, Bravo, M, Fusi, D, Pagani, M, Desalvo, L, Amalfitano, M, Zunino, Vanliut, M, Pirola, V, Campestrini, G, Agostini, S, Galdieri, M, Severino, A, Casula, C, Agus, G, Franceschini, L, Sarni, A, Vendrame, G, Frattini, F, Nardi, L, Valente, F, Rambelli, G, Rusconi, A, Taddei, G, Barbuscia, M, Cozzaglio, L, Regalia, E, Giudici, D, Gianotti, L, Baccari, P, Dalcin, S, Molene, V, Biffi, R, Gallitelli, L, Bianchi, G, Vecchi, G, Villa, E, Barzan, D, Mazzato, M, Pietromaggiori, F, Campisi, M, Palozzo, A, Inzalaco, M, Ricci, G, Castellucci, M, Maggiore, E, Salvadore, C, Grusovin, M, Mezzasalma, N, Maso, G, Pecorelli, O, Finco, C, Sartori, F, Buffano, G, Iacovelli, W, Ferri, T, Zermani, R, Rovati, P, Cebrelli, T, Pallavicini, F, Albertario, F, Bosco, A, Olivi, P, Paolini, P, Dalcanto, L, Marconcini, F, Lazzarini, R, Malacrida, A, Amboldi, A, Bonelli, S, Florianello, F, Borin, F, Vaghi, G, Fanelli, F, Mancini, S, Giusti, D, Nanni, G, Sannella, F, Sganga, G, Fellegara, P, Mosconi, F, Signorelli, I, Orban, D, Ceccherini, E, Orsini, A, Giuliano, P, Rosa, F, Zanella, A, Croatto, T, Toffanin, D, Binotto, F, Marcato, P, Menardo, G, Faucci, L, Spoldi, L, Marsetti, M, Dicosmo, L, Fornasetti, A, Manetti, A, Salvatore, A, Rossi, C, Rinaldi, S, Deangelis, C, Azzola, M, Conte, F, Rizzo, V, Bona, Mazzego, M, Leggieri, A, Canino, V, Pastore, V, Bosco, R, Debernardi, Disalvatore, A, Degrazia, R, Mazzon, D, Papadia, G, Toigo, G, Iscra, F, Nemez, M, Drobinz, F, Mesgez, D, Troncon, M, Bacco, A, Cattaruzzi, C, Cinque, A, Pasquetto, A, Cartei, G, Dibello, B, Miani, P, Chizzola, A, Baldassarre, M, Borga, P, Borgato, F, Scattolini, C, Laveggio, L, Franceschini, F, Turturo, F, Porretto, V, Coati, M, Nesi, L, Carner, M, Zampieri, P, Gabrielli, G, Todeschini, G, Falconi, M, Fratucello, G, Delgrossi, S, Citterio, R, Villa, C, Rivolta, A, Minuto, D, Orcalli, F, Ferrera, G, BRAGA M, BOZZETTI F, DIONIGI P, RADRIZZANI D, IAPICHINO G, SALIS C, SCROCCARO G, GELIO S, MESSORI A, TOGNONI G, ZANELLO M, FERRARA F, CORTI A, FANCHINI P, VERNERO S, CONGEDO RM, DECICCO M, MORELLI M, CARRATA R, LADDAGA L, LATTARULO M, MARCHESI G, SEQUENZA S, STIVALA B, LANZONE L, SOZZI P, RAITANO A, FIACCHI M, PIERANGELI A, RUSSITO G, CAPORALI C, BITTASI P, SANNA P, SAVONA G, USAI C, ACCOGLI P, SELLI L, PUSCEDDU P, IASIELLO G, FAZIO S, BADOINO C, BURLON N, LOMBARDI M, BERTANA P, BARTAZZI D, PAOLUCCI R, TELLA GC, CALLEGARI R, TOFFOLETTO F, TORREGGIANI L, CAMPO S, MICHELETTI I, LIDESTRI G, ZANIN P, GIULIANO G, CHIOLDI G, PERLASCA F, GRANDE W, PINCELLI D, PACCAGNELLA A, FRANCESCONI R, DOMENICONI D, BERTOTTI G, CAMPI A, VIVARELLI R, DONATI D, SIBILLA C, CERVI R, VANNUCCI A, TONELLI F, BRAVO MT, FUSI D, PAGANI M, DESALVO L, AMALFITANO ME, ZUNINO, VANLIUT MT, PIROLA V, CAMPESTRINI G, AGOSTINI S, GALDIERI MT, SEVERINO A, CASULA C, AGUS G, FRANCESCHINI L, SARNI A, VENDRAME G, FRATTINI F, NARDI L, VALENTE F, RAMBELLI G, RUSCONI A, TADDEI G, BARBUSCIA M, COZZAGLIO L, REGALIA E, GIUDICI D, GIANOTTI L, BACCARI P, DALCIN S, MOLENE V, BIFFI R, GALLITELLI L, BIANCHI G, VECCHI G, VILLA E, BARZAN D, MAZZATO M, PIETROMAGGIORI F, CAMPISI M, PALOZZO A, INZALACO M, RICCI G, CASTELLUCCI MG, MAGGIORE E, SALVADORE C, GRUSOVIN MT, MEZZASALMA N, MASO G, PECORELLI O, FINCO C, SARTORI F, BUFFANO G, IACOVELLI W, FERRI T, ZERMANI R, ROVATI P, CEBRELLI T, PALLAVICINI FB, ALBERTARIO F, BOSCO A, OLIVI P, PAOLINI P, DALCANTO L, MARCONCINI F, LAZZARINI R, MALACRIDA A, AMBOLDI A, BONELLI S, FLORIANELLO F, BORIN F, VAGHI GM, FANELLI FR, MANCINI S, GIUSTI D, NANNI G, SANNELLA F, SGANGA G, FELLEGARA P, MOSCONI F, SIGNORELLI I, ORBAN D, CECCHERINI E, ORSINI A, GIULIANO P, ROSA F, ZANELLA A, CROATTO T, TOFFANIN D, BINOTTO F, MARCATO P, MENARDO G, FAUCCI L, SPOLDI L, MARSETTI M, DICOSMO L, FORNASETTI A, MANETTI A, SALVATORE A, ROSSI C, RINALDI S, DEANGELIS C, AZZOLA M, CONTE F, RIZZO V, BONA, MAZZEGO M, LEGGIERI A, CANINO V, PASTORE V, BOSCO R, DEBERNARDI, DISALVATORE A, DEGRAZIA R, MAZZON D, PAPADIA G, TOIGO G, ISCRA F, NEMEZ M, DROBINZ F, MESGEZ D, TRONCON MG, BACCO A, CATTARUZZI C, CINQUE A, PASQUETTO A, CARTEI G, DIBELLO B, MIANI P, CHIZZOLA A, BALDASSARRE M, BORGA P, BORGATO F, SCATTOLINI C, LAVEGGIO L, FRANCESCHINI F, TURTURO F, PORRETTO V, COATI M, NESI L, CARNER M, ZAMPIERI P, GABRIELLI G, TODESCHINI G, FALCONI M, FRATUCELLO G, DELGROSSI S, CITTERIO R, VILLA C, RIVOLTA A, MINUTO D, ORCALLI F, FERRERA G, Braga, M, Bozzetti, F, Dionigi, P, Radrizzani, D, Iapichino, G, Salis, C, Scroccaro, G, Gelio, S, Messori, A, Tognoni, G, Zanello, M, Ferrara, F, Corti, A, Fanchini, P, Vernero, S, Congedo, R, Decicco, M, Morelli, M, Carrata, R, Laddaga, L, Lattarulo, M, Marchesi, G, Sequenza, S, Stivala, B, Lanzone, L, Sozzi, P, Raitano, A, Fiacchi, M, Pierangeli, A, Russito, G, Caporali, C, Bittasi, P, Sanna, P, Savona, G, Usai, C, Accogli, P, Selli, L, Pusceddu, P, Iasiello, G, Fazio, S, Badoino, C, Burlon, N, Lombardi, M, Bertana, P, Bartazzi, D, Paolucci, R, Tella, G, Callegari, R, Toffoletto, F, Torreggiani, L, Campo, S, Micheletti, I, Lidestri, G, Zanin, P, Giuliano, G, Chioldi, G, Perlasca, F, Grande, W, Pincelli, D, Paccagnella, A, Francesconi, R, Domeniconi, D, Bertotti, G, Campi, A, Vivarelli, R, Donati, D, Sibilla, C, Cervi, R, Vannucci, A, Tonelli, F, Bravo, M, Fusi, D, Pagani, M, Desalvo, L, Amalfitano, M, Zunino, Vanliut, M, Pirola, V, Campestrini, G, Agostini, S, Galdieri, M, Severino, A, Casula, C, Agus, G, Franceschini, L, Sarni, A, Vendrame, G, Frattini, F, Nardi, L, Valente, F, Rambelli, G, Rusconi, A, Taddei, G, Barbuscia, M, Cozzaglio, L, Regalia, E, Giudici, D, Gianotti, L, Baccari, P, Dalcin, S, Molene, V, Biffi, R, Gallitelli, L, Bianchi, G, Vecchi, G, Villa, E, Barzan, D, Mazzato, M, Pietromaggiori, F, Campisi, M, Palozzo, A, Inzalaco, M, Ricci, G, Castellucci, M, Maggiore, E, Salvadore, C, Grusovin, M, Mezzasalma, N, Maso, G, Pecorelli, O, Finco, C, Sartori, F, Buffano, G, Iacovelli, W, Ferri, T, Zermani, R, Rovati, P, Cebrelli, T, Pallavicini, F, Albertario, F, Bosco, A, Olivi, P, Paolini, P, Dalcanto, L, Marconcini, F, Lazzarini, R, Malacrida, A, Amboldi, A, Bonelli, S, Florianello, F, Borin, F, Vaghi, G, Fanelli, F, Mancini, S, Giusti, D, Nanni, G, Sannella, F, Sganga, G, Fellegara, P, Mosconi, F, Signorelli, I, Orban, D, Ceccherini, E, Orsini, A, Giuliano, P, Rosa, F, Zanella, A, Croatto, T, Toffanin, D, Binotto, F, Marcato, P, Menardo, G, Faucci, L, Spoldi, L, Marsetti, M, Dicosmo, L, Fornasetti, A, Manetti, A, Salvatore, A, Rossi, C, Rinaldi, S, Deangelis, C, Azzola, M, Conte, F, Rizzo, V, Bona, Mazzego, M, Leggieri, A, Canino, V, Pastore, V, Bosco, R, Debernardi, Disalvatore, A, Degrazia, R, Mazzon, D, Papadia, G, Toigo, G, Iscra, F, Nemez, M, Drobinz, F, Mesgez, D, Troncon, M, Bacco, A, Cattaruzzi, C, Cinque, A, Pasquetto, A, Cartei, G, Dibello, B, Miani, P, Chizzola, A, Baldassarre, M, Borga, P, Borgato, F, Scattolini, C, Laveggio, L, Franceschini, F, Turturo, F, Porretto, V, Coati, M, Nesi, L, Carner, M, Zampieri, P, Gabrielli, G, Todeschini, G, Falconi, M, Fratucello, G, Delgrossi, S, Citterio, R, Villa, C, Rivolta, A, Minuto, D, Orcalli, F, Ferrera, G, BRAGA M, BOZZETTI F, DIONIGI P, RADRIZZANI D, IAPICHINO G, SALIS C, SCROCCARO G, GELIO S, MESSORI A, TOGNONI G, ZANELLO M, FERRARA F, CORTI A, FANCHINI P, VERNERO S, CONGEDO RM, DECICCO M, MORELLI M, CARRATA R, LADDAGA L, LATTARULO M, MARCHESI G, SEQUENZA S, STIVALA B, LANZONE L, SOZZI P, RAITANO A, FIACCHI M, PIERANGELI A, RUSSITO G, CAPORALI C, BITTASI P, SANNA P, SAVONA G, USAI C, ACCOGLI P, SELLI L, PUSCEDDU P, IASIELLO G, FAZIO S, BADOINO C, BURLON N, LOMBARDI M, BERTANA P, BARTAZZI D, PAOLUCCI R, TELLA GC, CALLEGARI R, TOFFOLETTO F, TORREGGIANI L, CAMPO S, MICHELETTI I, LIDESTRI G, ZANIN P, GIULIANO G, CHIOLDI G, PERLASCA F, GRANDE W, PINCELLI D, PACCAGNELLA A, FRANCESCONI R, DOMENICONI D, BERTOTTI G, CAMPI A, VIVARELLI R, DONATI D, SIBILLA C, CERVI R, VANNUCCI A, TONELLI F, BRAVO MT, FUSI D, PAGANI M, DESALVO L, AMALFITANO ME, ZUNINO, VANLIUT MT, PIROLA V, CAMPESTRINI G, AGOSTINI S, GALDIERI MT, SEVERINO A, CASULA C, AGUS G, FRANCESCHINI L, SARNI A, VENDRAME G, FRATTINI F, NARDI L, VALENTE F, RAMBELLI G, RUSCONI A, TADDEI G, BARBUSCIA M, COZZAGLIO L, REGALIA E, GIUDICI D, GIANOTTI L, BACCARI P, DALCIN S, MOLENE V, BIFFI R, GALLITELLI L, BIANCHI G, VECCHI G, VILLA E, BARZAN D, MAZZATO M, PIETROMAGGIORI F, CAMPISI M, PALOZZO A, INZALACO M, RICCI G, CASTELLUCCI MG, MAGGIORE E, SALVADORE C, GRUSOVIN MT, MEZZASALMA N, MASO G, PECORELLI O, FINCO C, SARTORI F, BUFFANO G, IACOVELLI W, FERRI T, ZERMANI R, ROVATI P, CEBRELLI T, PALLAVICINI FB, ALBERTARIO F, BOSCO A, OLIVI P, PAOLINI P, DALCANTO L, MARCONCINI F, LAZZARINI R, MALACRIDA A, AMBOLDI A, BONELLI S, FLORIANELLO F, BORIN F, VAGHI GM, FANELLI FR, MANCINI S, GIUSTI D, NANNI G, SANNELLA F, SGANGA G, FELLEGARA P, MOSCONI F, SIGNORELLI I, ORBAN D, CECCHERINI E, ORSINI A, GIULIANO P, ROSA F, ZANELLA A, CROATTO T, TOFFANIN D, BINOTTO F, MARCATO P, MENARDO G, FAUCCI L, SPOLDI L, MARSETTI M, DICOSMO L, FORNASETTI A, MANETTI A, SALVATORE A, ROSSI C, RINALDI S, DEANGELIS C, AZZOLA M, CONTE F, RIZZO V, BONA, MAZZEGO M, LEGGIERI A, CANINO V, PASTORE V, BOSCO R, DEBERNARDI, DISALVATORE A, DEGRAZIA R, MAZZON D, PAPADIA G, TOIGO G, ISCRA F, NEMEZ M, DROBINZ F, MESGEZ D, TRONCON MG, BACCO A, CATTARUZZI C, CINQUE A, PASQUETTO A, CARTEI G, DIBELLO B, MIANI P, CHIZZOLA A, BALDASSARRE M, BORGA P, BORGATO F, SCATTOLINI C, LAVEGGIO L, FRANCESCHINI F, TURTURO F, PORRETTO V, COATI M, NESI L, CARNER M, ZAMPIERI P, GABRIELLI G, TODESCHINI G, FALCONI M, FRATUCELLO G, DELGROSSI S, CITTERIO R, VILLA C, RIVOLTA A, MINUTO D, ORCALLI F, and FERRERA G

Abstract

A multicentre prospective survey on the use of artificial nutrition (AN) and its complications has been carried out on 1657 hospitalised patients including 7.8% in surgical departments, 7.1% in medical departments and 59.9% in intensive care units. Gastrointestinal diseases and cancer were the most frequent pathologies among patients requiring AN. Parenteral nutrition (PN) alone was employed in 1103 (66.5%) patients. In 267 (16.1%) PN was associated with enteral nutrition (EN). 287 (17.3%) patients were fed by the enteral route alone. The average daily energy intake was 35 kcal/kg for central PN, 26 kcal/kg for peripheral PN and 33 kcal/kg for EN. The mean daily nitrogen intake was 0.19 g/kg for central PN, 0.17 g/kg for peripheral PN and 0.20 g/kg for EN. In 10% of patients PN was electrolyte free and in only 50% all the main electrolytes were added. Trace elements were added in 48% of formulations, mainly as multiple combination. Insulin was added in 61% of PN patients, while albumin was given with PN in 20% of patients. Adverse reactions were observed in 10.9% of PN patients and in 11.5% of EN patients. The most frequent complications occurring in parenterally fed patients were infections of the central venous catheter and metabolic alterations (severe electrolyte abnormalities, liver or renal dysfunction, hypo or persistent hyperglycemia). In enterally fed patients the frequent complications were abdominal distension, cramps and diarrhoea. Adverse reactions were responsible for discontinuation of AN in 2.2% of parenterally supported patients and in 5.7% of enterally fed patients.

Published
1994

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