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perioperative artificial nutrition in malnourished gastrointestinal cancer patients

World Journal of Gastroenterology 2006年第15期12卷 2441-2444页

作者： Guo-Hao Wu Zhong-Hua Liu Zhao-Han Wu Zhao-Guang Wu Department of General Surgery Z-hongshan-HospitalFudan University Shanghai 200032 China

AIM： To investigate the potential role of perioperative nutrition in reducing complications and mortality in malnourished gastrointestinal cancer patients. METHODS： Four hundred and sixty-eight elective moderately or severely malnourished surgical patients with gastric or colorectal cancers defined by the subjective global assessment （SGA） were randomly assigned to 7 d preoperative and 7 d postoperative parenteral or enteral nutrition vs a simple control group. The nutrition regimen included 24.6±5.2 kcal /kg per d non-protein and 0.23±0.04 g nitrogen /kg per d. Control patients did not receive preoperative nutrition but received 600±100 kcal non-protein plus or not plus 62 ± 16 g crystalline amino acids postoperatively. RESULTS： Complications occurred in 18.3% of the patients receiving nutrition and in 33.5% of the control patients （P= 0.012）. Fourteen patients died in the control group and 5 in those receiving nutrition. There were significant differences in the mortality between the two groups （2.1% vs 6.0%, P=0.003）. The total length of hospitalization and postoperative stay of control patients were significantly longer （29 vs 22 d, P=0.014） than those of the studied patients （23 vs 12 d, P= 0.000）. CONCLUSION： perioperative nutrition support is beneficial for moderately or severely malnourished gastrointestinal cancer patients and can reduce surgical complications and mortality.

关键词： Malnutrition perioperative nutrition Parenteral nutrition Enteral nutrition Mortality Complications

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Enhanced recovery after surgery:Progress in adapted pathways for implementation in standard and emerging surgical settings

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World Journal of Clinical Cases 2024年第25期12卷 5636-5641页

作者： Mohamed Wishahi Nabawya M Kamal Mohamed Saied Hedaya Department of Urology Theodor Bilharz Research InstituteCairo 12411Egypt Department of Anaesthesia and Surgical Intensive Care Theodor Bilharz Research InstituteCairo 12411Egypt Department of Surgery Theodore Bilharz Research InstituteCairo 12411Egypt

The concept of enhanced recovery after surgery(ERAS)has been practiced for decades and has been implemented in numerous surgical *** is a global surgical quality improvement initiative,and it is an element in the field of perioperative *** had shown significant clinical outcomes,patientreported satisfaction,and improvements in medical service *** has been developed for specific surgical procedures,but with the fast progress of newly introduced surgical procedures,the original ERAS have been developed and *** appearing Topics and future research trends encompass ERAS protocols for other types of surgery and the enhancement of perioperative status,including but not limited to pediatric surgery,laparoscopic and robotic assisted surgery,bariatric surgery,thoracic surgery,and renal *** elements and pathways of ERAS have been developed with the introduction of up-to-date methodologies in the pre-operative,operative,and post-operative *** costs are higher than traditional care,but the patient’s clinical outcome and satisfaction are *** is in progress in the fields of anesthetic tasks,pediatric surgery,and organ *** ERAS has shown significant clinical outcomes,there are needs to modify the protocol for specific cases,hospital facilities,resources,and nurses training on elements of *** challenges and limitations exist in the implementation of ERAS that deserve consideration,it includes:Frailty,maximizing nutrition,prehabilitation,treating preoperative anemia,and enhancing ERAS adoption globally are all included.

关键词： Enhanced recovery after surgery Anesthesia Nurses Elderly Bowel preparation ERAS perioperative nutrition Major&ambulatory surgery

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