[In which patients and for which procedures has the efficacy of postoperative artificial nutrition be proven?]

This study reviewed 19 prospective studies for the incidence of postoperative nutritional support on outcome in elective surgery. It compared enteral and parenteral nutrition initiated no more than three days preoperatively or postoperatively and prolonged maximally for one month, to a simple infusion of glucose or saline. As all studies had methodological weaknesses, concerning mainly the sample size, it is impossible to propose relevant recommendations. Nevertheless, among the 11 studies on total parenteral nutritional support (nitrogen and caloric supply with carbohydrates and/or lipids), three of them produced valuable results. As the available data do not show any beneficial effect, a routine postoperative nutritional support cannot be recommended, even in patients at high risk of postoperative complications. However for the latter a possible benefit cannot be totally excluded in some of them. When an alimentation per mouth cannot be started during the 8 to 10 days after surgery, an artificial nutritional support becomes mandatory.