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 .
Randomized Clinical Trial: Nasoenteric Tube or Jejunostomy as a Route for Nutrition After Major Upper Gastrointestinal Operations
Abstract Background Curative treatment of upper gastrointestinal tract neoplasms is complex and associated with high morbidity and mortality . In general , the patients are already malnourished , and early postoperative enteral nutrition is recommended . However , there is no consensus concerning the best enteral access route in these cases . Methods A prospect i ve r and omized trial was performed from 2008 to 2012 with 59 patients who underwent esophagectomy , total gastrectomy , or pancreaticoduodenectomy .  In all , 4 patients declined to participate , and 13 did not meet the inclusion criteria and were excluded . Of the 42 included patients , 21 had nasoenteric tubes , and 21 had a jejunostomy . Results The two groups were similar in demographic and clinical aspects . The nasoenteric ( NE ) and jejunostomy groups underwent early enteral therapy in 71 and 62 % of cases ( p > 0.05 ) , respectively . The median length of enteral therapy use was less in the NE group ( 5.0 vs. 8.5 days ) , but the difference was not statistically significant . The NE group required introduction of parenteral therapy more frequently than the jejunostomy group ( p < 0.05 ) . Complications related to the enteral route occurred in 38.0 and 28.5 % of patients ( p > 0.05 ) in the NE and jejunostomy groups , respectively . In the NE group , there were four losses and four tube obstructions . In the jejunostomy group , there were two losses , four obstructions , and two cases of leakage around the tube . In the latter group , patients who underwent therapy for a longer time had tubal complications ( p < 0.05 ) and longer intensive care unit and hospital stays ( p < 0.05 ) . Conclusion The two enteral routes were associated with the same number of complications . However , the presence of a jejunostomy allowed enteral therapy for longer periods , especially in patients with complications , thus avoiding the need for parenteral nutrition
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 .