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 .
Impact of home enteral nutrition in malnourished patients with upper gastrointestinal cancer: A multicentre randomised clinical trial.
BACKGROUND Weight loss is frequent in patients with gastrointestinal ( GI ) cancer . Nutritional status deteriorates throughout anti-cancer treatment , mostly after major surgery , increasing complications , reducing tolerance and worsening the final prognosis . Enteral nutrition is safe and effective in malnourished patients undergoing major GI surgery . R and omised trials aim ed at investigating the effects of home enteral nutrition ( HEN ) in post-surgical patients with GI cancer are lacking . This study compares HEN and counselling in limiting weight loss during oncologic treatment . PATIENTS AND METHODS Patients with upper GI cancer and c and i date to major surgery were included in the protocol when the nutritional risk screening ( NRS 2002 ) score was ≥3 . All patients were supported with enteral nutrition through a jejunostomy after surgery and r and omly assigned to continue enteral nutrition or receiving nutritional counselling after discharge . Nutritional and performance status , quality of life ( QoL ) and tolerance to cancer treatment have been evaluated at 2 and 6 months after discharge . RESULTS Seventy-nine patients were r and omised ; 38 continued enteral nutrition at home and 41 patients received nutritional counselling only . After 2 months , patients on HEN  maintained their mean body weight , while patients in the nutritional counselling group showed a weight loss of 3.6 kg . Patients supported on HEN had a higher chance to  complete chemotherapy  as planned ( 48 % versus 34 % ) . QoL was not worsened by HEN . No complications were reported . CONCLUSIONS HEN is a simple and feasible treatment to support malnourished patients with upper GI cancer after major surgery and during chemotherapy in order to limit further weight loss
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 .