Grant: Operating Grant

Loss of muscle protein and mass are the main causes of fatigue after bowel surgery which may result in a longer hospital stay and a higher rate of complications. This problem is especially relevant for patients after surgery for bowel cancer because cancer itself causes a waste of muscle protein. Anesthesiologists can decrease the muscle wasting after surgery by choosing the type of pain treatment (analgesia) and by giving nutrition (sugar and protein). Our group recently observed that optimal pain relief with epidural catheters (these are placed in the so called epidural space, which lies between the spine and the skin of the back) in combination with a low calorie protein diet intravenously (through the vein) maintains the body's protein stores after bowel cancer surgery. The goal of our new research program is to find out whether this protein saving effect of excellent pain control and nutrition can be further improved by adding the hormone insulin to our therapy. We recently have developed a safe way to give insulin to patients who have cancer surgery and expect that insulin together with a high protein diet will lead to the optimal preservation of protein in muscle and other vital organs. Optimizing nutritional therapy will help patients to better overcome the stress of surgery and, eventually, improve their recovery.