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J.Jpn. Surg. Soc.. 111(3): 149-155, 2010


Feature topic

PERIOPERATIVE NUTRITIONAL SUPPORT FROM THE VIEWPOINT OF RISK MANAGEMENT

Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan

Yoshiaki Tanaka, Takahiro Asakawa, Nobuyuki Saikusa, Sinichiro Kojima, Yoshinori Koga, Naoki Hashizume, Hitoshi Iida, Minoru Yagi

The nutritional condition of perioperative patients affects the results of surgical treatment. For a better prognosis, surgeons must always consider patients' nutritional status preoperatively. After first assessing the nutritional status, a regimen to improve and/or maintain proper nutrition should be selected taking symptoms and treatment procedure into consideration. Peripheral parenteral nutrition provides limited energy. If patients' nutritional status requires improvement and they must fast for a long term, total parenteral nutrition should be administered. Parenteral nutrition is nonphysiologic therapy and may have severe complications. During the administration of enteral nutrition via a gastrointestinal fistula or nasogastric tube, vomiting and incorrect infusion due to the improper positioning of the feeding tube may occur. When administering nutrition therapy via a gastrostomy or intestinal fistula, care must be taken to determine the appropriate dose and infusion rate. To provide suitable nutritional therapy, our knowledge of the various options available must be expanded.


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