[Parenteral nutrition in surgery preparation in large intestinal diseases. Indication, procedure and results]

The basic problem of colonic surgery is the high septic risk. Especially chronic inflammatory diseases are marked by a high periintestinal infection rate. In addition, there are catabolisms with negative protein balance and immunologic deficiency. In order to avoid there factors the principle of withdrawal of the intestinal function has been applied. Patients are put on a balanced high-caloric and completely absorable diet (2,400-3,600 cal) using a thin duodenal tube for several weeks. Depending on the initial condition the alimentation is carried out in some patients parenterally or as a supplement. From 1966 to 1981 240 patients with ulcerative and granulomatous inflammatory diseases of the colon were operated on at the Surgical Department of the University Hospital Hamburg. Using this preparation the rate of infection decreased from 54 to 14%, and the mortality resulting from septic complications from 13 to 0.8%. The main achievement of withdrawal of the intestinal function is the reduction of extraintestinal secondary infection which is responsible for the septic complications.