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Invited Commentary
March 16, 2022

Early Postoperative Supplementary Parenteral Nutrition

Author Affiliations
  • 1Faculty of Medicine and Health, School of Health and Medical Sciences, Department of Surgery, Örebro University, Örebro, Sweden
  • 2Department of Surgery and Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
  • 3Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, Nottingham Biomedical Research Centre, National Institute for Health Research, Queen’s Medical Centre, Nottingham University Hospital NHS Trust, University of Nottingham, Nottingham, United Kingdom
  • 4MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham, United Kingdom
JAMA Surg. 2022;157(5):393-394. doi:10.1001/jamasurg.2022.0266

Perioperative nutritional therapy has been a key, albeit somewhat neglected, aspect of perioperative care ever since Studley1 showed that patients with a preoperative weight loss of more than 20% had a 10-fold greater mortality after an operation for perforated peptic ulcer than those with a weight loss of less than 20%. Although many other studies have linked malnutrition with adverse postoperative outcome, perioperative nutritional optimization is still far from universal. Enhanced Recovery After Surgery programs recommend early oral nutrition, but this is dependent on early recovery of gastrointestinal function, which is in turn dependent on implementation of multimodal interventions aimed at aiding postoperative recovery.2 Even with ideal preoperative and intraoperative care, optimal early oral nutrition may not be possible in all patients, especially those undergoing major upper gastrointestinal or pancreatic operations.

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