Goal-directed Enteral Nutritional Perioperative Management

Exclusion Criteria

• •1. NRS 2002 score \< 3;
• •2. Upfront surgery without neoadjuvant treatment;
• •3. Any comorbidity interferes with the digestion and absorption of ORAL IMPACT®;
• •4. Receiving any other nutritional support during the study;
• •5. Unable to consume nutrition orally or receive it through tube feeding before surgery;
• •6. History of other malignancies in the past 5 years, except successfully treated basal-cell skin carcinoma and cervical tumors in situ;
• •7. Severe abnormalities of liver and kidney functions (ALT≥2 times the upper limit of normal; Total bilirubin Tbil≥2 upper limit of normal; Creatinine Cr≥2 upper limit of normal);
• •8. Metabolic disorders, including uncontrolled diabetes mellitus or fasting blood glucose ≥10mmol/L, hypothyroidism, or hyperthyroidism;
• •9. Receiving fat emulsion containing Omega-3 fatty acids, glutamine, thymosin, glucocorticoid, thyroxine, growth hormone, and anti-tumor necrosis factor biologic agents
• •10. History of known allergy to any component of ORAL IMPACT®;
• •11. Pregnant or lactating women, women of childbearing potential with either a positive pregnancy test at baseline or not using a reliable and appropriate contraceptive method;
• •12. Refuse to sign the consent or unable to follow the study protocol;
• •13. Inappropriate to participate in this study judged by investigators.