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 .
Safety, feasibility, and tolerance of early oral feeding after colorectal resection outside an enhanced recovery after surgery (ERAS) program
Introduction It is generally believed that resumption of feeding after colorectal resection is indicated only after recovery of bowel function . This study was design ed to verify safety , feasibility , and tolerance of early oral postoperative feeding ( EOF ) outside an enhanced recovery after surgery ( ERAS ) program . Material s and methods One hundred patient c and i date s to elective colorectal resection were prospect ively enrolled in an EOF program . Feeding was started on postoperative day ( POD ) 1 with oral nutritional supplement ( ONS ) . On POD 2 , patients had normal food plus ONS to reach 1,000–1,200 kcal/day with progressive increase until 1,800–2,000 kcal/day . Results were compared with historical controls ( n = 100 ) in whom oral feeding was allowed only after full bowel function recovery . The ERAS program was not applied in both groups . Results The EOF group had a better recovery of short half-life protein synthesis compared with the control group ( P < 0.001 ) . Stool canalization occurred after a median of 3 days ( range , 1–6 days ) in the EOF group versus 5 days ( range , 2–8 days ) in the control group ( P = 0.001 ) . The feeding protocol was completed in 89 patients within POD 5 . Tolerance to resumption of feeding was similar in the two groups . The overall rate of postoperative complication was 22 % in the EOF group vs. 27 % in the control group ( P = 0.51 ) . The median length of hospitalization was 9 days ( range , 6–25 days ) in the EOF group vs. 12 days ( range , 6–31 days ) in controls ( P = 0.01 ) . Conclusions EOF after colorectal operations is feasible and safe outside an ERAS program
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 .