From clinical guidelines to practice: The nutrition elements for enhancing recovery after colorectal surgery

Hasil, Leslee; Fenton, Tanis R.; Ljungqvist, Olle; Gillis, Chelsia

doi:10.1002/ncp.10751

Cited by 8 publications

(2 citation statements)

References 108 publications

(264 reference statements)

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“…Key components include preoperative optimization 8 , 18 , 21 , 31 , 34 , 35 , which focuses on patient preparation and risk mitigation, intraoperative strategies such as balanced anesthesia and minimally invasive techniques, and postoperative care involving pain management 30 , early mobilization 62 , and nutrition 60 . Perioperative nutrition plays an important role in enhanced recovery protocols especially by improving the nutritional condition of the patient before and after surgery as well as reducing the fasting period 8 , 18 , 25 , 32 , 36 . Multimodal analgesia, a cornerstone of these protocols, utilizes a combination of analgesic agents to minimize reliance on opioids, thereby reducing side effects and promoting quicker recovery 17 , 30 , 31 .…”

Section: Introductionmentioning

confidence: 99%

“…Clinical trials in surgical patients have investigated the impact of immune-enhancing nutrition, including arginine and omega-3 fatty acids, on postoperative outcomes 1 , 32 , 36 , 56 , 60 . These studies suggest a reduction in infectious complications, including surgical site infections, in patients receiving these nutritional interventions.…”

Section: Introductionmentioning

confidence: 99%

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Perioperative Care in Digestive Surgery: The Eras and Acerto Protocols - Brazilian College of Digestive Surgery Position Paper

AGUILAR-NASCIMENTO,

RIBEIRO JUNIOR,

PORTARI-FILHO

et al. 2024

ABCD, arq. bras. cir. dig.

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Background: The concept introduced by enhanced recovery after surgery protocols modifies perioperative traditional care in digestive surgery. The integration of these modern recommendations components during the perioperative period are highly important to ensure less postoperative complications, reduced length of hospital stay and decreased surgical costs. Aims: The aim of this position paper is to emphasize the most important points of a multimodal perioperative care protocol. Methods: A careful analysis of each recommendation of both ERAS and ACERTO protocols is presented, justifying its inclusion in the recommended multimodal care of digestive surgery patients. Results: Enhanced recovery programs (ERPs) such as ERAS and ACERTO protocols are a cornerstone in modern perioperative care. Nutritional therapy is highly important in digestive surgery and thus both preoperative and postoperative nutrition care are key to ensure less postoperative complications and to reduce the length of hospital stay. The concept of prehabilitation is another key element in ERPs. Management of crystalloid fluids in a perfect balance in vital. Fluid overload may delay the recovery of patients and increase postoperative complications. Abbreviation of preoperative fast for 2h before anesthesia is now accepted by various guidelines of both surgical and anesthesiology societies. Combined with early postoperative refeeding, these prescriptions are not only safe but can also enhance recovery of patients undergoing digestive procedures. Conclusions: This Brazilian College of Digestive Surgery position paper strongly emphasizes that the implementation of ERPs in digestive surgery represents a paradigm shift in perioperative care, transcending traditional practices and embracing an intelligent approach to patient well-being. Background: The concept introduced by enhanced recovery after surgery protocols modifies perioperative traditional care in digestive surgery. The integration of these modern recommendations components during the perioperative period are highly important to ensure less postoperative complications, reduced length of hospital stay and decreased surgical costs. Aims: The aim of this position paper is to emphasize the most important points of a multimodal perioperative care protocol. Methods: A careful analysis of each recommendation of both ERAS and ACERTO protocols is presented, justifying its inclusion in the recommended multimodal care of digestive surgery patients. Results: Enhanced recovery programs (ERPs) such as ERAS and ACERTO protocols are a cornerstone in modern perioperative care. Nutritional therapy is highly important in digestive surgery and thus both preoperative and postoperative nutrition care are key to ensure less postoperative complications and to reduce the length of hospital stay. The concept of prehabilitation is another key element in ERPs. Management of crystalloid fluids in a perfect balance in vital. Fluid overload may delay the recovery of patients and increase postoperative complications. Abbreviation of preoperative fast for 2h before anesthesia is now accepted by various guidelines of both surgical and anesthesiology societies. Combined with early postoperative refeeding, these prescriptions are not only safe but can also enhance recovery of patients undergoing digestive procedures. Conclusions: This Brazilian College of Digestive Surgery position paper strongly emphasizes that the implementation of ERPs in digestive surgery represents a paradigm shift in perioperative care, transcending traditional practices and embracing an intelligent approach to patient well-being.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perioperative Care in Digestive Surgery: The Eras and Acerto Protocols - Brazilian College of Digestive Surgery Position Paper

AGUILAR-NASCIMENTO,

RIBEIRO JUNIOR,

PORTARI-FILHO

et al. 2024

ABCD, arq. bras. cir. dig.

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Implementing early feeding after liver transplant using implementation frameworks: A multimethod study

Takefala,

Mayr,

Doola

et al. 2024

Nut in Clin Prac

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BackgroundEvidence‐based guidelines (EBGs) in the nutrition management of advanced liver disease and enhanced recovery after surgery recommendations state that normal diet should recommence 12–24 h following liver transplantation. This study aimed to compare postoperative nutrition practices to guideline recommendations, explore clinician perceptions regarding feeding after transplant surgery, and implement and evaluate strategies to improve postoperative nutrition practices.MethodsA pre‐post multimethod implementation study was undertaken, guided by the knowledge‐to‐action framework. A retrospective chart audit of postoperative dietary practice and semistructured interviews with clinicians were undertaken. Implementation strategies were informed by the Consolidated Framework for Implementation Research–Expert Recommendations for Implementing Change matching tool and then evaluated.ResultsAn evidence‐practice gap was identified, with the median day to initiation of nutrition (free‐fluid or full diet) on postoperative day (POD) 2 and only 25% of patients aligning with the EBGs. Clinician interviews identified belief in the importance of nutrition, with variation in surgical practice in relation to early nutrition, competing clinical priorities, and vulnerabilities in communication contributing to delays in returning to feeding. An endorsed postoperative nutrition protocol was implemented along with a suite of theory‐ and stakeholder‐informed intervention strategies. Following implementation, the median time to initiate nutrition reduced to POD1 and alignment with EBGs improved to 60%.ConclusionThis study used implementation frameworks and strategies to understand, implement, and improve early feeding practices in line with EBGs after liver transplant. Ongoing sustainability of practice change as well as the impact on clinical outcomes have yet to be determined.

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Efficacy of Prehabilitation in Abdominal Cancer Surgery

Edbrooke,

Abo,

Denehy

2024

Recent Strategies in High Risk Surgery

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From clinical guidelines to practice: The nutrition elements for enhancing recovery after colorectal surgery

Cited by 8 publications

References 108 publications

Perioperative Care in Digestive Surgery: The Eras and Acerto Protocols - Brazilian College of Digestive Surgery Position Paper

Perioperative Care in Digestive Surgery: The Eras and Acerto Protocols - Brazilian College of Digestive Surgery Position Paper

Implementing early feeding after liver transplant using implementation frameworks: A multimethod study

Efficacy of Prehabilitation in Abdominal Cancer Surgery

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