[Nutritional management of anastomotic leakage after gastrointestinal surgery--with special reference to the serious...

Effects of intravenous hyperalimentation (IVH) were studied in 38 patients with anastomotic leakage following gastrointestinal surgery. Spontaneous closure of the leakage were found in 23 patients (60%), and surgical closure were needed in 9 patients (24%). The duration required for spontaneous closure was 5 weeks on the average; and closure occurred readily in cases of tubular fistula. Death occurred in 6 patients (16%); among these, 5 were MOF cases. The following three points are emphasized concerning measures to increase IVH efficacy in serious cases such as MOF. GFX-solution is efficacious for reduced glucose tolerance. Administration of canrenoate potassium(Soldactone), linoleic acid and BCAA enriched amino-acid mixture is effective for accelerated albumin synthesis. Concomitant treatment by IVH and ED(elemental diet) is efficacious in cases of high caloric administration.