[The effect of nutritional support on the perioperative course in patients after extensive surgical procedures]

Nutritional treatment in patient undergoing extensive surgical procedures is a condition of shortening of catabolic phase of postoperative period. Giving a basal quantity of nutritional components, authors tried to do a clinical evaluation of treated patients and possibilities of the nutritional treatment in a provincial hospital. 51 patients was fed parenterally or/and enterally, all-in-one admixtures or with multi- bottles system, with using of peristaltic/infusion pump or gravity. Patients were divided into 4 groups: 1. treated with laparostomy because of pancreatic necrosis or complications of acute pancreatitis, 2. with complications after total or subtotal gastrectomy, 3. with complications after extensive resections of jejunum or colon Clinical status, weight loss, accessible laboratory investigations were studied. Authors gave on the average: energy 32 kcal/kg b.m./day, protein 0.15 gN/kg b.m./day, potassium 1.15 mEq/kg b.m./day. In 37 patients appeared weight loss av. 4.8 kg. In 20 patients with decreased serum protein level or blood cell count-plasma and erythrocytes were applied. In examined groups 9 persons died because of myocardial infarction, pulmonary embolism, intestinal necrosis with peritonitis, lesions of CNS following trauma, sepsis.

1. Effective treatment of postoperative complications is possible with application of nutritional treatment. 2. Adequate (not excessive) nutritional components administration should be applied intravenously, enterally or by both of them.