Abstract
Purpose: While enhanced recovery after surgery (ERAS) programmes are the standard of perioperative management special nutritional care has to be attributed to malnourished patients and those at metabolic risk with special regard to those with complications.
Methods: Existing guidelines of the German and European societies of nutritional medicine (DGEM, ESPEN) on enteral and parenteral nutrition in surgery were merged and in accordance with the principles of the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF; German Association of the Scientific Medical Societies) and Arztliches Zentrum fur Qualitat in der Medizin (AeZQ; German Agency for Quality in Medicine) revised and extended.
Results: Theworking group developed 41 consensus- based recommendations for perioperative nutrition. The recommendation strength is: 9x A (recommendation based on significant literature of good quality, at least one randomized controlled trial), 12x B (recommendation based on well-designed trial without randomization), 13x C (recommendation based on expert opinions and/or clinical experience of respected authorities) und 7x CCP (clinical consensus point).
Conclusion: Even in patients without obvious malnutrition perioperative nutritional support is indicated when oral food intake is not feasible or inadequate for a longer period of time.