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 controlled trial of six weeks of home enteral nutrition versus standard care after oesophagectomy or total gastrectomy for cancer: report on a pilot and feasibility study
Background Poor nutrition in the first months after oesophago-gastric resection is a contributing factor to the reduced quality of life seen in these patients . The aim of this pilot and feasibility study was to ascertain the feasibility of conducting a multi-centre r and omised controlled trial to evaluate routine home enteral nutrition in these patients . Methods Patients undergoing oesophagectomy or total gastrectomy were r and omised to either six weeks of home feeding through a jejunostomy ( intervention ) , or treatment as usual ( control ) . Intervention comprised overnight feeding , providing 50 % of energy and protein requirements , in addition to usual oral intake . Primary outcome measures were recruitment and retention rates at six weeks and six months . Nutritional intake , nutritional parameters , quality of life and healthcare costs were also collected . Interviews were conducted with a sample of participants , to ascertain patient and carer experiences . Results Fifty-four of 112 ( 48 % ) eligible patients participated in the study over the 20 months . Study retention at six weeks was 41/54 patients ( 76 % ) and at six months was 36/54 ( 67 % ) . At six weeks , participants in the control group had lost on average 3.9 kg more than participants in the intervention group ( 95 % confidence interval [ CI ] 1.6 to 6.2 ) . These differences remained evident at three months ( mean difference 2.5 kg , 95 % CI −0.5 to 5.6 ) and at six months ( mean difference 2.5 kg , 95 % CI −1.2 to 6.1 ) . The mean values observed in the intervention group for mid arm circumference , mid arm muscle circumference , triceps skin fold thickness and right h and grip strength were greater than for the control group at all post hospital discharge time points . The economic evaluation suggested that it was feasible to collect re source use and EQ-5D data for a full cost-effectiveness analysis . Thematic analysis of 15 interviews identified three main themes related to the intervention and the trial : 1 ) a positive experience , 2 ) the reasons for taking part , and 3 ) uncertainty of the study process . Conclusions This study demonstrated that home enteral feeding by jejunostomy was feasible , safe and acceptable to patients and their carers . Whether home enteral feeding as ’ usual practice ’ is a cost-effective therapy would require confirmation in an appropriately powered , multi-centre study .Trial registration UK Clinical Research Network ID 12447 ( main trial , first registered 30 May 2012 ) ; UK Clinical Research Network ID 13361 ( qualitative sub study , first registered 30 May 2012 ) ; Clinical Trials.gov NCT01870817 ( first registered 28 May 2013
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 .