Extending the benefit of nutrition intervention beyond the operative setting

Nogueira, Paulo L. Reis; Dock-Nascimento, Diana Borges; Aguilar-Nascimento, José Eduardo de

doi:10.1097/mco.0000000000000868

Cited by 3 publications

(2 citation statements)

References 41 publications

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“…The combination of whey protein and carbohydrate supplementation administered three hours before the anesthesia induction has gained attention within the ACERTO protocol as a potential strategy to further optimize preoperative nutritional status and positively impact surgical outcomes 17 , 44 , 46 , 47 . Whey protein, the so-called fast protein, is easily digestible and absorbed, rich in essential amino acids, and has been recognized for its ability to stimulate protein synthesis and enhance muscle preservation.…”

Section: Introductionmentioning

confidence: 99%

“…Whey protein, the so-called fast protein, is easily digestible and absorbed, rich in essential amino acids, and has been recognized for its ability to stimulate protein synthesis and enhance muscle preservation. When combined with carbohydrates, this nutritional strategy is not only safe but also provides a dual benefit by supporting both protein anabolism and maintaining glycogen stores 3 , 46 , 47 .…”

Section: Introductionmentioning

confidence: 99%

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Perioperative Care in Digestive Surgery: The Eras and Acerto Protocols - Brazilian College of Digestive Surgery Position Paper

AGUILAR-NASCIMENTO,

RIBEIRO JUNIOR,

PORTARI-FILHO

et al. 2024

ABCD, arq. bras. cir. dig.

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Background: The concept introduced by enhanced recovery after surgery protocols modifies perioperative traditional care in digestive surgery. The integration of these modern recommendations components during the perioperative period are highly important to ensure less postoperative complications, reduced length of hospital stay and decreased surgical costs. Aims: The aim of this position paper is to emphasize the most important points of a multimodal perioperative care protocol. Methods: A careful analysis of each recommendation of both ERAS and ACERTO protocols is presented, justifying its inclusion in the recommended multimodal care of digestive surgery patients. Results: Enhanced recovery programs (ERPs) such as ERAS and ACERTO protocols are a cornerstone in modern perioperative care. Nutritional therapy is highly important in digestive surgery and thus both preoperative and postoperative nutrition care are key to ensure less postoperative complications and to reduce the length of hospital stay. The concept of prehabilitation is another key element in ERPs. Management of crystalloid fluids in a perfect balance in vital. Fluid overload may delay the recovery of patients and increase postoperative complications. Abbreviation of preoperative fast for 2h before anesthesia is now accepted by various guidelines of both surgical and anesthesiology societies. Combined with early postoperative refeeding, these prescriptions are not only safe but can also enhance recovery of patients undergoing digestive procedures. Conclusions: This Brazilian College of Digestive Surgery position paper strongly emphasizes that the implementation of ERPs in digestive surgery represents a paradigm shift in perioperative care, transcending traditional practices and embracing an intelligent approach to patient well-being. Background: The concept introduced by enhanced recovery after surgery protocols modifies perioperative traditional care in digestive surgery. The integration of these modern recommendations components during the perioperative period are highly important to ensure less postoperative complications, reduced length of hospital stay and decreased surgical costs. Aims: The aim of this position paper is to emphasize the most important points of a multimodal perioperative care protocol. Methods: A careful analysis of each recommendation of both ERAS and ACERTO protocols is presented, justifying its inclusion in the recommended multimodal care of digestive surgery patients. Results: Enhanced recovery programs (ERPs) such as ERAS and ACERTO protocols are a cornerstone in modern perioperative care. Nutritional therapy is highly important in digestive surgery and thus both preoperative and postoperative nutrition care are key to ensure less postoperative complications and to reduce the length of hospital stay. The concept of prehabilitation is another key element in ERPs. Management of crystalloid fluids in a perfect balance in vital. Fluid overload may delay the recovery of patients and increase postoperative complications. Abbreviation of preoperative fast for 2h before anesthesia is now accepted by various guidelines of both surgical and anesthesiology societies. Combined with early postoperative refeeding, these prescriptions are not only safe but can also enhance recovery of patients undergoing digestive procedures. Conclusions: This Brazilian College of Digestive Surgery position paper strongly emphasizes that the implementation of ERPs in digestive surgery represents a paradigm shift in perioperative care, transcending traditional practices and embracing an intelligent approach to patient well-being.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perioperative Care in Digestive Surgery: The Eras and Acerto Protocols - Brazilian College of Digestive Surgery Position Paper

AGUILAR-NASCIMENTO,

RIBEIRO JUNIOR,

PORTARI-FILHO

et al. 2024

ABCD, arq. bras. cir. dig.

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The effect of early supplemental parental nutrition in patients after pancreaticoduodenectomy

Han,

Lim

et al. 2024

Preprint

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Background/OBJECTIVES: Pancreaticoduodenectomy (PD) has multi-potential factors for malnutrition as its surgical boundary covers organs with digestive juices. The utility of supplemental parental nutrition (PN) is controversial for patients underwent PD. This study aimed to investigate clinical effect of using routine supplemental-PN after PD.SUBJECTS/Methods: From 2014 to 2020, 927 patients undergoing PD in Samsung Medical Center were divided into two groups, those who used routine supplemental-PN (n = 161) and those who did not (n = 766) and analyzed retrospectively. The routine supplemental-PN was administered to patients by using PN with oral feeding together, started after immediate postoperative 1–3 days without interruption. A subgroup analysis was performed for patients with diabetes mellitus (DM) and sarcopenia.Results Regarding postoperative complications, the supplemental-PN group had significantly higher rates of postoperative pancreatic fistula (POPF) (p < 0.001) and delayed gastric emptying (p = 0.012) than the non-PN group. The supplemental-PN group had similar hospital stay to the non-PN group (p = 0.547). In subgroup analysis for those with DM (n = 252), the supplemental-PN group had significantly higher postoperative major complications (37.5 vs. 20.6%, p = 0.016), especially POPF (27.1 vs. 10.8%, p = 0.006), than the non-PN group. For sarcopenic patients (n = 89), the supplemental-PN group had significantly longer hospital stay than the non-PN group (13.7 days vs. 11.4 days, p = 0.040).Conclusion In terms of postoperative complications, routine use of supplemental-PN after PD is not beneficial for patients. Especially with DM and sarcopenia, its use needs caution.

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Bibliometric analysis of research trends in relationship between sarcopenia and surgery

Liu

Song

et al. 2023

Front. Surg.

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BackgroundThe relationship between sarcopenia and surgery has attracted an increasing number of researchers in recent years. Our study aimed to identify the current research hotspot and status in this field by using bibliometric and visualization analysis.MethodsPublications about the relationship between sarcopenia and surgery that met the inclusion criteria were collected from the Science Citation Index Expanded. The bibliometric and visualized studies were performed using VOSviewer, and R.ResultsA total of 2,261 documents on the relationship between sarcopenia and surgery were included in our study. These articles were written by 13,757 authors from 2,703 institutions in 70 countries and were published in 772 journals. The USA is the most productive and influential country in this field (524 publications and 15,220 citations). The Udice French Research Universities was the most productive institution in this field (57 publications), and the University of Alberta had the largest number of citations. Annuals of Surgical Oncology published the most studies in this field. Shen Xian was the most productive author in this field (number of publications = 19), and Baracos Vickie was the most influential author, whose studies in this field had been cited 2,209 times. The cluster analysis was performed and visualized, and the keywords were classified into 6 clusters: Cluster 1 (body composition and nutrition), Cluster 2 (sarcopenia), Cluster 3 (malnutrition and cachexia), Cluster 4 (cancer surgery), Cluster 5 (elderly and frailty), Cluster 6 (neuromuscular scoliosis).ConclusionThe relationship between sarcopenia and surgery was still a controversial and well-discussed topic in recent years. Our study showed that the study in this field mainly focused on sarcopenia, oncology surgery, orthopedics, and nutrition.

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Extending the benefit of nutrition intervention beyond the operative setting

Cited by 3 publications

References 41 publications

Perioperative Care in Digestive Surgery: The Eras and Acerto Protocols - Brazilian College of Digestive Surgery Position Paper

Perioperative Care in Digestive Surgery: The Eras and Acerto Protocols - Brazilian College of Digestive Surgery Position Paper

The effect of early supplemental parental nutrition in patients after pancreaticoduodenectomy

Bibliometric analysis of research trends in relationship between sarcopenia and surgery

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