The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .
Nutritional approach in malnourished surgical patients: a prospective randomized study.
HYPOTHESIS Perioperative administration of a supplemented enteral formula may decrease postoperative morbidity . DESIGN R and omized clinical trial . SETTING Department of surgery at a university hospital . PATIENTS One hundred ninety-six registered malnourished patients ( weight loss > or = 10 % ) who were c and i date s for major elective surgery for malignancy of the gastrointestinal tract . INTERVENTION After r and omization ( n = 150 ) , one group received postoperative enteral feeding with a st and ard diet within 12 hours of surgery ( control group ; n = 50 ) . Another group orally received 1 L/d for 7 consecutive days of a liquid diet enriched with arginine , omega-3 fatty acids , and RNA ( preoperative group ; n = 50 ) . After surgery , patients were given the same st and ard enteral formula as the control group . A third group orally received 1 L/d for 7 consecutive days of the enriched liquid diet . After surgery , patients were given enteral feeding with the same enriched formula ( perioperative group ; n = 50 ) . MAIN OUTCOME MEASURES Postoperative complications and length of hospital stay . RESULTS The 3 groups were comparable for baseline demographics , biochemical markers , comorbidity factors , and surgical variables . The intent-to-treat analysis showed that the total number of patients with complications was 24 in the control group , 14 in the preoperative group , and 9 in the perioperative group ( P = .02 , control group vs perioperative group ) . Postoperative length of stay was significantly shorter in the preoperative ( 13.2 days ) and perioperative ( 12.0 days ) groups than in the control group ( 15.3 days ) ( P = .01 and P = .001 , respectively , vs the control group ) . CONCLUSION Perioperative immunonutrition seems to be the best approach to support malnourished patients with cancer
The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .