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Perioperative nutritional support.

Jesús Manuel Morán López1, María Piedra León2, María Teresa García Unzueta3

  • 1Unidad de Endocrinología y Nutrición, Hospital San Pedro de Alcántara, Cáceres, España.

Cirugia Espanola
|April 8, 2014
PubMed
Summary

Preoperative malnutrition increases surgical risks. Early enteral nutrition and immunonutrition post-surgery can reduce complications and hospital stays, replacing traditional bowel rest and parenteral nutrition.

Keywords:
InmunonutriciónInmunonutritionInsulinorresistencia perioperatoriaPerioperative insulin resistencePerioperative nutritional supportSoporte nutricional perioperatorio

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Area of Science:

  • Surgical Nutrition
  • Perioperative Medicine

Background:

  • Preoperative malnutrition is linked to increased surgical morbidity and mortality.
  • Despite available detection tools, clinical adoption for malnutrition management is limited.
  • Perioperative insulin resistance and hyperglycemia correlate with adverse outcomes and longer hospital stays.

Purpose of the Study:

  • To evaluate the impact of early enteral nutrition and immunonutrition on postoperative outcomes.
  • To assess the effectiveness of carbohydrate-rich drinks in reducing perioperative insulin resistance.
  • To advocate for the adoption of these nutritional strategies over traditional bowel rest and parenteral nutrition.

Main Methods:

  • Administration of carbohydrate-rich drinks 2-4 hours pre-surgery.
  • Early initiation of enteral nutrition in the postoperative period.
  • Implementation of immunonutrition protocols.

Main Results:

  • Early enteral nutrition is safe, well-tolerated, and reduces hospital stay and complications compared to parenteral support.
  • Immunonutrition effectively decreases postoperative complications and length of hospital stay.
  • Preoperative carbohydrate intake improves insulin resistance.

Conclusions:

  • Adopting early enteral nutrition and immunonutrition can significantly improve surgical patient outcomes.
  • These strategies offer a superior alternative to prolonged bowel rest and routine parenteral nutrition.
  • Optimizing perioperative nutrition is crucial for reducing surgical morbidity and mortality.