this guideline reflects the recommendations of the group of specialists of the Brazilian College of Surgeons , the Brazilian Society of Parenteral and Enteral Nutrition and the ACERTO Project for nutritional interventions in the perioperative period of Elective General Surgery .
The prescription of these recommendations can accelerate the postoperative recovery of patients su bmi tted to elective general surgery , with decrease in morbidity , length of stay and rehospitalization , and consequently , of costs
OBJECTIVE to present recommendations based on the ACERTO Project ( Acceleration of Total Post-Operative Recovery ) and supported by evidence related to perioperative nutritional care in General Surgery elective procedures .
A randomised trial of post-discharge enteral feeding following surgical resection of an upper gastrointestinal malignancy.
BACKGROUND Patients undergoing upper gastrointestinal surgery often eat poorly post-operatively , despite dietetic input . A pilot study was conducted to examine the benefit of a 6 week nutritional supplementation via a feeding jejunostomy on fatigue , quality of life and independent living . METHODS A feeding jejunostomy was placed routinely at oesophagectomy or total gastrectomy for cancer . At discharge , patients were r and omised to nutritional supplementation ( 600 kcal/day ) via their feeding jejunostomies or no jejunal supplement . Patients were assessed at discharge and 3 , 6 , 12 and 24 weeks following discharge for fatigue ( MFI-20 ) , quality of life ( QLQ-OES18 ) , health economic analysis ( EQ5D ) as well as completing a two-day dietary diary . RESULTS 44 patients ( M : F , 29:15 ) were r and omised , 23 received jejunal supplements . There were no differences between the groups . Percentage of calculated energy requirement received was greater in the supplemented group at weeks 3 and 6 ( p < 0.0001 ) . Oral energy intake was not different between the groups at any time period . After hospital discharge , there were no differences in MFI-20 , EQ5D and QLQ-OES18 scores at any time point . From hospital discharge fatigue improved and plateaued at 6 weeks ( p < 0.05 for both groups ) , independence at 12 weeks ( p < 0.05 for both groups ) . No improvement was seen in quality of life until 24 weeks in the active group alone ( p < 0.02 ) and not at all in the control group . CONCLUSIONS Addition of jejunal feeding is effective in providing patients with an adequate energy intake . Increased energy intake however , produced no obvious improvement in measures of fatigue , quality of life or health economics
this guideline reflects the recommendations of the group of specialists of the Brazilian College of Surgeons , the Brazilian Society of Parenteral and Enteral Nutrition and the ACERTO Project for nutritional interventions in the perioperative period of Elective General Surgery .
The prescription of these recommendations can accelerate the postoperative recovery of patients su bmi tted to elective general surgery , with decrease in morbidity , length of stay and rehospitalization , and consequently , of costs
OBJECTIVE to present recommendations based on the ACERTO Project ( Acceleration of Total Post-Operative Recovery ) and supported by evidence related to perioperative nutritional care in General Surgery elective procedures .