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PERIOPERATIVE NUTRITIONAL SUPPORT IN GASTROINTESTINAL SURGERY - WHY IS IT ESSENTIAL?
Daniéla Oliveira Magro1, Amanda Pereira Lima1, Cláudio Saddy Rodrigues Coy1
1Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Departamento de Cirurgia, Campinas, SP, Brasil.
Arquivos De Gastroenterologia
|June 18, 2025
Summary
Preoperative nutritional screening is vital for gastrointestinal surgery patients. Addressing malnutrition and obesity through interventions like oral supplementation or nutritional support can reduce complications and improve outcomes.
Area of Science:
- Surgical Nutrition
- Gastrointestinal Surgery Outcomes
- Patient Recovery
Background:
- Malnutrition, sarcopenia, and obesity significantly increase risks in gastrointestinal surgery, including complications, mortality, and prolonged hospital stays.
- Unintentional weight loss over 10% is a key mortality predictor, while malnutrition affects 17-20% of patients, raising infectious complication risks.
- Obesity (BMI ≥30.0 kg/m2) also worsens surgical outcomes and hospital mortality.
Purpose of the Study:
- To highlight the critical role of preoperative nutritional status assessment in gastrointestinal surgery.
- To emphasize the importance of perioperative nutritional support for enhancing patient recovery.
- To advocate for a comprehensive approach to nutritional management in surgical patients.
Main Methods:
- Discusses the American Gastroenterological Association (AGA) guidelines for malnutrition assessment, including BMI and clinical signs.
- Reviews the use of oral supplementation, enteral nutrition (EN), and parenteral nutrition (PN) for malnourished patients.
- Highlights the eligibility of all patients for preoperative nutritional screening, irrespective of their nutritional status.
Main Results:
- Nutritional status significantly impacts surgical outcomes, with modifiable factors like weight loss being crucial.
- Early identification and intervention for malnutrition and obesity can mitigate postoperative complications.
- Standardized screening and tailored nutritional support are essential components of enhanced recovery pathways.
Conclusions:
- Comprehensive preoperative nutritional screening and perioperative support are essential for improving patient quality of life.
- Addressing malnutrition and obesity preoperatively can lead to reduced postoperative complications and healthcare costs.
- A unified approach to perioperative nutrition is necessary to optimize outcomes in gastrointestinal surgery.
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