Perioperative Nutrition

Abstract

Perioperative nutrition is a vitally important yet often overlooked aspect of surgical care. Significant disparity exists between evidenced-based recommendations and practices encouraged by traditional surgical teaching. The metabolic response to surgical stress is complex. Poor nutrition has been demonstrated to correlate with adverse surgical outcomes. Perioperative nutrition encompasses preoperative, intraoperative, and postoperative care. Preoperative nutritional assessment identifies at-risk patients who benefit from supplementation before surgery. Prehabilitation seeks to prepare patients for the impending surgical stress. Immunonutrition seems to provide a benefit, although its precise mechanisms are unknown. This article provides a review of the current state of perioperative nutrition.

Nutrition in peri-operative esophageal cancer management

“…Furthermore, it is now increasingly recognized that fasting for this length of time depletes glycogen storage before the start of surgery. This depletion creates a situation in which lean body mass is sacrificed during the actual surgical procedure to meet energy demands [66]. To attenuate the loss of skeletal muscle, the preoperative addition of carbohydrate supplements has gained attention over the last few years [66].…”

“…This depletion creates a situation in which lean body mass is sacrificed during the actual surgical procedure to meet energy demands [66]. To attenuate the loss of skeletal muscle, the preoperative addition of carbohydrate supplements has gained attention over the last few years [66]. So far, studies on fasting and carbohydrate loading have been performed in surgery for several indications, but not in esophagectomy.…”

Infection in central venous catheter led by parenteral nutrition of tumor patients

“…In recent years, tolerance and safety of PN have been further improved with continuous improvement of nutrient solution formulation and infusion technology. PN not only provides effective nutritional support for critically ill patients and patients who cannot be ingest through the gastrointestinal tract but has also become an integral part of clinical treatment [9]. Currently, patients who benefit more from PN experience intestinal obstruction, short bowel syndrome, tumor cachexia, severe malnutrition, and metabolic diseases (such as severe burns and severe infections).…”

Enhanced Recovery After Surgery

“…While surgically induced insulin resistance can be treated with insulin therapy, preventative measures help minimize its occurrence when implemented prior to and during surgery and therefore increase successful outcome. For instance, avoiding long periods of starvation and preoperative administration of oral carbohydrate fluid have been established as a means of minimizing postoperative insulin resistance 22 – 25 …”

“…This depletion creates a situation whereby lean body mass is sacrificed during the actual operation to meet energy demands. To attenuate the loss of skeletal muscle, carbohydrate supplements are given before surgery 24 . In a double‐blind, randomized controlled trial (RCT) that investigated insulin sensitivity and β‐cell function before and after elective hip replacement surgery, 57 patients randomized to carbohydrate oral fluid or water prior to surgery showed the same decrease in insulin sensitivity after surgery.…”