[Recent progress in the perioperative management in gastrointestinal surgery]

Area of Science:

• Surgical Innovation
• Patient Recovery Protocols

Background:

• The past 50 years have seen significant advancements in gastrointestinal surgery, particularly with the advent of minimally invasive techniques.
• Perioperative management has evolved to incorporate damage control surgery and the principles of early recovery after surgery (ERAS).

Discussion:

• Accurate diagnosis, nutritional assessment, and correction of malnutrition are fundamental prerequisites for successful gastrointestinal operations.
• Mastery of surgical techniques and appropriate instrument selection, tailored to patient's preoperative status, are key to minimizing tissue damage and postoperative complications.
• Effective postoperative analgesia is vital for promoting early patient mobilization, accelerating recovery, and potentially reducing cardiopulmonary complications.

Key Insights:

• Early enteral feeding aids in restoring gastrointestinal function, preserving the gut barrier, and preventing gut dysbiosis, thereby facilitating patient recovery.
• Comprehensive perioperative care, encompassing nutritional support and advanced surgical approaches, is essential for optimizing outcomes in gastrointestinal surgery.

Outlook:

• Future research should focus on refining minimally invasive techniques and further integrating ERAS protocols to enhance patient recovery trajectories.
• Continued exploration into the role of nutritional optimization and gut microbiome modulation in surgical recovery is warranted.