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 .
Perioperative Enteral Immunonutrition Modulates Systemic and Mucosal Immunity and the Inflammatory Response in Patients With Periampullary Cancer Scheduled for Pancreaticoduodenectomy: A Randomized Clinical Trial
Objectives Nutritional deficiencies and immune dysfunction in cancer patients may contribute to postoperative septic morbidity . This trial compared the effects of perioperative enteral immunonutrition ( EIN ) versus st and ard enteral nutrition ( SEN ) on systemic and mucosal immunity in patients undergoing pancreaticoduodenectomy for periampullary cancer . Methods Thirty-seven patients were r and omized ( EIN , n = 17 ; SEN , n = 20 ) to receive feed for 14 days preoperatively and 7 days postoperatively . Mediators of systemic immunity ( interleukin 1&agr ; , tumor necrosis factor & agr ; , lymphocytes subsets , and complement components ) and of mucosal immunity in duodenal biopsies , nutritional markers and parameters were evaluated . Results The groups were comparable for demographics , the concentrations of mediators of systemic and mucosal immunity at time of recruitment , and for the duration and amount of feed received . Preoperative EIN rather than SEN was associated with significant reductions in plasma tumor necrosis factor & agr ; and total hemolytic complement . Enteral immunonutrition – fed patients had significantly higher total lymphocyte count on the third postoperative day and significantly greater rise in CD4/CD8 ratio from day 3 to day 7 postoperatively compared with SEN-fed patients . Conclusions The perioperative administration of EIN rather than SEN is associated with a favorable modulation of the inflammatory response and enhancement of systemic immunity in patients undergoing pancreaticoduodenectomy for periampullary cancer
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 .