Contemporary Perioperative Nutritional Care

Author:

Ljungqvist Olle12,Weimann Arved3,Sandini Marta4,Baldini Gabriele5,Gianotti Luca67

Affiliation:

1. 1Department of Surgery, School of Medical Sciences, Orebro University Hospital and Orebro University, Orebro, Sweden; email: olle.ljungqvist@oru.se

2. 2Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden

3. 3Department of General, Visceral, and Oncologic Surgery, Saint George Hospital, Leipzig, Germany

4. 4Department of Medicine, Surgery, and Neuroscience and Unit of General and Oncologic Surgery, University of Siena, Siena, Italy

5. 5Section of Anesthesia and Critical Care, Department of Anesthesia and Critical Care, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy

6. 6School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy

7. 7HPB Surgery, Foundation IRCCS San Gerardo Hospital, Monza, Italy

Abstract

Over the last decades, surgical complication rates have fallen drastically. With the introduction of new surgical techniques coupled with specific evidence-based perioperative care protocols, patients today run half the risk of complications compared with traditional care. Many patients who in previous years needed weeks of hospital care now recover and can leave in days. These remarkable improvements are achieved by using nutritional stress-reducing care elements for the surgical patient that reduce metabolic stress and allow for the return of gut function. This new approach to nutritional care and how it is delivered as an integral part of enhancing recovery after surgery are outlined in this review. We also summarize the new and increased understanding of the effects of the routes of delivering nutrition and the role of the gut, as well as the current recommendations for artificial nutritional support.

Publisher

Annual Reviews

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