Perioperative nutritional support: a randomised clinical trial

Meyenfeldt, M.F. von; Meijerink, W. J. H. J.; Rouflart, M.; Builmaassen, M.T.H.J.; Soeters, Peter B.

doi:10.1016/0261-5614(92)90026-m

Cited by 260 publications

(94 citation statements)

References 29 publications

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“…142 Overnight treatment with glucose prevents postoperative decrease in insulin sensitivity 30,146 and early loss of protein after gastrointestinal surgery [147][148][149] and augments voluntary muscle function. 150 Clinical studies conducted in small patient populations reported better outcomes with preoperative nutrition 112,130,[151][152][153][154] and emphasize that avoidance of fasting makes patients less susceptible to complications and may decrease hospital length of stay. 27,[154][155][156] In contrast, the results of a larger randomized controlled trial showed no significant benefit.…”

Section: Assessment Of Catabolism Before Surgerymentioning

confidence: 99%

Perioperative catabolism

Schricker

Lattermann

2015

Can J Anesth/J Can Anesth

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Section: Assessment Of Catabolism Before Surgerymentioning

confidence: 99%

Perioperative catabolism

Schricker

Lattermann

2015

Can J Anesth/J Can Anesth

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“…20,21 It frequently occurs with comorbidities and with underlying disease processes, such as cancer. 22 Inadequate nutrition, particularly for cancer patients undergoing surgery, is an independent risk factor for complications, increased hospital stay and costs. 23 The importance of nutritional status in patients undergoing radical cystectomy has long been noted, 24 with reported complications rates as high as 80% in patients with poor nutrition.…”

Section: Preoperative Nutritionmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Melnyk

Casey

Black

et al. 2013

CUAJ

275

120

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Radical cystectomy with pelvic lymph node dissection remains the standard treatment for patients with muscle invasive bladder cancer. Despite improvements in surgical technique, anesthesia and perioperative care, radical cystectomy is still associated with greater morbidity and prolonged in-patient stay after surgery than other urological procedures. Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response following surgery. The key elements of ERAS protocols include preoperative counselling, optimization of nutrition, standardized analgesic and anesthetic regimens and early mobilization. Despite the significant body of evidence indicating that ERAS protocols lead to improved outcomes, they challenge traditional surgical doctrine, and as a result their implementation has been slow.The present article discusses particular aspects of ERAS protocols which represent fundamental shifts in surgical practice, including perioperative nutrition, management of postoperative ileus and the use of mechanical bowel preparation.

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“…The effects of malnutrition on various organ systems and wound healing have been evaluated in experimental and clinical studies; particularly, its effects on the gastrointestinal system have been emphasized (3,(6)(7)(8). Some clinical studies have indicated lower general complication rates by preoperative nutritional support in patients with malnutrition undergoing major gastrointestinal surgery (9)(10)(11). However, there is little experimental research on this topic.…”

Section: Introductionmentioning

confidence: 99%

The effects of pre-operative nutrition on colon anastomosis healing in malnourished rats

Gündoğdu¹,

Yaşar²,

Ersoy³

et al. 2015

UCD

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Objective: It has been proven that malnutrition increases postoperative morbidity and mortality, and it may also negatively affect wound healing in the gastrointestinal tract. In the literature, there is only one study evaluating the effects of preoperative nutritional support on colonic anastomotic healing under malnourished conditions. In order to improve the data on this topic, an experimental study was planned to evaluate the effects of preoperative nutritional support on colonic anastomotic healing in malnourished rats. Material and Methods:The study included 18 male Wistar albino rats divided into 3 groups. The control (C) group was fed ad libitum for 21 days. The malnutrition (M) group and preoperative nutrition (P) group were given 50% of the daily food consumed by the rats in Group C for 21 days to induce malnutrition. At the end of 21 days, Group P was fed ad libitum for 7 days (preoperative nutritional support). Colonic transection and end-to-end anastomosis was performed at 21 days in Group C and Group M and at 28 days in Group P. The rats were sacrificed at postoperative 4 days, anastomotic bursting pressure was measured, and samples were taken to analyze tissue hydroxyproline levels.Results: Anastomotic bursting pressure was significantly higher in Group C than in Group M and Group P (p<0.05), and it was significantly higher in Group P than in Group M (p<0.05). Tissue hydroxyproline levels in Group P were found to be significantly higher than those in Group M and Group C (p<0.05). Conclusion:One week of preoperative nutritional support increases collagen synthesis in the colon and positively affects anastomotic healing under malnourished conditions.

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Perioperative nutritional support: a randomised clinical trial

Cited by 260 publications

References 29 publications

Perioperative catabolism

Perioperative catabolism

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

The effects of pre-operative nutrition on colon anastomosis healing in malnourished rats

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