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Perioperative nutritional management in digestive tract surgery
Örebro University, School of Health and Medical Sciences.ORCID iD: 0000-0003-2636-4745
2011 (English)In: Current opinion in clinical nutrition and metabolic care, ISSN 1363-1950, E-ISSN 1473-6519, Vol. 14, no 5, p. 504-509Article in journal (Refereed) Published
Abstract [en]

Purpose of review This article reviews the recent research on perioperative nutrition in digestive tract surgery in the light of modern perioperative care principles, that is, enhanced recovery after surgery (ERAS). Four major directions of research emerge: detecting malnutrition, perioperative hyperglycemia/insulin resistance, enteral/parenteral nutrition and immunonutrition. Recent findings For preoperative nutritional screening/assessment, current data cannot single out superiority for SGA questionnaire, nutritional risk score, Reilly's nutritional risk score or nutritional risk index in the ability to predict nutrition-related complications. The use of ERAS elements to reduce surgical stress and preclude postoperative insulin resistance has recently been clearly linked to reductions in adverse outcomes. There are specific situations in which enteral nutrition is contraindicated and criterias for preoperative and postoperative parenteral nutrition in undernourished patients are defined in guidelines recently available. Several controlled randomized studies and systematic reviews indicate that immune nutrition formulas reduce both morbidity and length of stay after major abdominal surgery. Summary To reduce surgical stress, insulin resistance, unnecessary protein losses and postoperative complications, the use of an ERAS protocol is important. Current data shows that the use of perioperative immunonutrition diets for major abdominal surgery is beneficial. Further research on nutritional assessment tools to predict who is at risk for postoperative complications is needed.

Place, publisher, year, edition, pages
2011. Vol. 14, no 5, p. 504-509
Keywords [en]
enhanced recovery after surgery, immunonutrition and surgery, perioperative nutrition, postoperative hyperglycemia
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-26017DOI: 10.1097/MCO.0b013e3283499ae1ISI: 000293783500015OAI: oai:DiVA.org:oru-26017DiVA, id: diva2:556779
Available from: 2012-09-26 Created: 2012-09-26 Last updated: 2017-12-07Bibliographically approved

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Ljungqvist, Olle

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