ESPEN Guidelines on Clinical nutrition in surgery - Special issues to be revisited

Weimann, Arved; Wobith, Maria

doi:10.1016/j.ejso.2022.10.002

Cited by 9 publications

(8 citation statements)

References 51 publications

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“…So when referring to preoperative therapy, for patients with advanced age, we must pay attention to both nutrition support and function exercise, to improve long-term nutrition and function problems caused by aging, and increase preoperative reservation, which was defined as “prehabilitation” and needed a relatively longer period ( 36 ). And for cancer patients with nutritional risk or malnutrition, we should commit to increasing intake and improving nutrition status by different support routes even for a short period ( 16 , 37 ). Prealbumin might be a biomarker to monitor the effectiveness of preoperative nutrition support but needs further study.…”

Section: Discussionmentioning

confidence: 99%

Relationship between preoperative malnutrition, frailty, sarcopenia, body composition, and anthropometry in elderly patients undergoing major pancreatic and biliary surgery

Wang

et al. 2023

Front. Nutr.

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ObjectiveTo analyze the correlation between preoperative nutritional status, frailty, sarcopenia, body composition, and anthropometry in geriatric inpatients undergoing major pancreatic and biliary surgery.MethodsThis is a cross-sectional study of the database from December 2020 to September 2022 in the department of hepatopancreatobiliary surgery, Beijing Hospital. Basal data, anthropometry, and body composition were recorded. NRS 2002, GLIM, FFP 2001, and AWGS 2019 criteria were performed. The incidence, overlap, and correlation of malnutrition, frailty, sarcopenia, and other nutrition-related variables were investigated. Group comparisons were implemented by stratification of age and malignancy. The present study adhered to the STROBE guidelines for cross-sectional study.ResultsA total of 140 consecutive cases were included. The prevalence of nutritional risk, malnutrition, frailty, and sarcopenia was 70.0, 67.1, 20.7, and 36.4%, respectively. The overlaps of malnutrition with sarcopenia, malnutrition with frailty, and sarcopenia with frailty were 36.4, 19.3, and 15.0%. There is a positive correlation between every two of the four diagnostic tools, and all six p-values were below 0.002. Albumin, prealbumin, CC, GS, 6MTW, ASMI, and FFMI showed a significantly negative correlation with the diagnoses of the four tools. Participants with frailty or sarcopenia were significantly more likely to suffer from malnutrition than their control groups with a 5.037 and 3.267 times higher risk, respectively (for frailty, 95% CI: 1.715–14.794, p = 0.003 and for sarcopenia, 95% CI: 2.151–4.963, p<0.001). Summarizing from stratification analysis, most body composition and function variables were worsen in the ≥70 years group than in the younger group, and malignant patients tended to experience more intake reduction and weight loss than the benign group, which affected the nutrition diagnosis.ConclusionElderly inpatients undergoing major pancreatic and biliary surgery possessed high prevalence and overlap rates of malnutrition, frailty, and sarcopenia. Body composition and function deteriorated obviously with aging.

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Section: Discussionmentioning

confidence: 99%

Relationship between preoperative malnutrition, frailty, sarcopenia, body composition, and anthropometry in elderly patients undergoing major pancreatic and biliary surgery

Wang

et al. 2023

Front. Nutr.

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“…Evidence points toward immunonutrition as a potent avenue for modulating metabolic and immune trajectories [14]. The European Society for Clinical Nutrition and Metabolism (ESPEN) posits that patients undergoing upper gastrointestinal cancer surgeries should opt for enteral immunonutrition to curtail significant infectious complications [15]. Numerous inquiries indicate that EIN therapy can attenuate postoperative complications and inflammatory manifestations, curtailing hospital durations and bolstering the patient quality of life [12,16,17].…”

Section: Discussionmentioning

confidence: 99%

Perioperative Enteral Immunonutrition Support for the Immune Function and Intestinal Mucosal Barrier in Gastric Cancer Patients Undergoing Gastrectomy: A Prospective Randomized Controlled Study

Ma,

Zheng,

Zeng

et al. 2023

Nutrients

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Objective: The impact of perioperative immunonutrition on patients undergoing radical gastrectomy remains undetermined. This study aimed to assess the influence of enteral immunonutrition support on postoperative immune function and intestinal mucosal barrier function following radical gastrectomy, contrasting findings with a control group to furnish evidence for perioperative enteral nutrition support. Methods: In this prospective randomized trial, 65 patients who underwent radical gastrectomy between June 2022 and June 2023 were included. Participants were allocated to either the study group (receiving enteral immunonutrition) or the control group (not receiving enteral immunonutrition). We compared postoperative rehabilitation and complications between the groups, analyzed the intestinal mucosal barrier function markers on the 3rd and 7th postoperative days, and delved deeper into peripheral blood cell immunity, inflammation, and nutritional indicators. Results: The cohort consisted of 30 patients in the study group and 35 in the control group, with no significant differences in demographic attributes between the two groups. On the 3rd postoperative day, the diamine oxidase, D-lactic acid, and endotoxin levels in the study group were significantly lower than those in the control group (p = 0.029, p = 0.044, and p = 0.010, respectively). By the 7th postoperative day, these levels continued to be significantly diminished in the study group (p = 0.013, p = 0.033, and p = 0.004, respectively). The times to first flatus (p = 0.012) and first bowel movement (p = 0.012) were significantly shorter in the study group. Moreover, postoperative complications in the study group were fewer than in the control group (p = 0.039). On the 7th postoperative day, the study group had lower peripheral white blood cell (WBC) levels (p = 0.020) and neutrophil–lymphocyte ratios (NLR) (p = 0.031), but displayed elevated albumin levels (p = 0.006). One month post-surgery, the CD4+T and CD8+T counts were significantly greater in the study group (p = 0.003 and p = 0.012, respectively). Correlation analyses indicated that NLR and complications were associated with endotoxin levels. Conclusion: Administering perioperative enteral immunonutrition enhances postoperative immune and intestinal mucosal barrier functions in patients undergoing radical gastrectomy. This effect leads to diminished inflammatory responses, a decreased rate of postoperative complications, and accelerated patient recovery.

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“…They generally are accepted in patients at high nutritional risk or who present with underlying malignancies and benefit from a decreased incidence of infectious complications. 6,55 In opposition, their use is not supported by the ERAS®-Esophagectomy protocol due to lack of significant evidence. 25 Braga et al evaluated patients with malnutrition as candidates for major elective surgery due to malignancy of the gastrointestinal tract.…”

Section: Enhanced Recovery After Surgerymentioning

confidence: 99%

Optimizing Nutritional Status of Patients Prior to Major Surgical Intervention

Sanchez Leon,

Rajaraman,

Kubwimana

2023

Methodist DeBakey Cardiovascular Journal

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In patients undergoing elective cardiovascular and thoracic surgery, malnutrition and the deterioration of nutritional status are associated with negative outcomes. Recognition of the contributory factors and the complications stemming from surgical stress is important for the prevention and management of these patients. We have reviewed the literature available and focused on the nutritional and metabolic aspects affecting surgical patients, with emphasis on the recommendations of enhanced recovery protocols. The implementation of enhanced recovery protocols and nutritional support guidelines focusing on the surgical patient as part of a multidisciplinary approach would improve the nutritional status of surgical patients at risk for negative outcomes.

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ESPEN Guidelines on Clinical nutrition in surgery - Special issues to be revisited

Cited by 9 publications

References 51 publications

Relationship between preoperative malnutrition, frailty, sarcopenia, body composition, and anthropometry in elderly patients undergoing major pancreatic and biliary surgery

Relationship between preoperative malnutrition, frailty, sarcopenia, body composition, and anthropometry in elderly patients undergoing major pancreatic and biliary surgery

Perioperative Enteral Immunonutrition Support for the Immune Function and Intestinal Mucosal Barrier in Gastric Cancer Patients Undergoing Gastrectomy: A Prospective Randomized Controlled Study

Optimizing Nutritional Status of Patients Prior to Major Surgical Intervention

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