[Clinical nutrition in surgery. Guidelines of the German Society for Nutritional Medicine].
BACKGROUND
While enhanced recovery after surgery (ERAS) programs are the standard for perioperative management, special nutritional care has to be administered to malnourished patients and those at metabolic risk with special regard to patients with postoperative complications.


METHODS
Existing guidelines of the German and European societies of nutritional medicine (DGEM and 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 Ärztliches Zentrum für Qualität in der Medizin (AeZQ, German Agency for Quality in Medicine) revised and extended.


CONCLUSIONS
The working group developed 41 consensus-based recommendations for perioperative nutrition. The recommendation strength is: 9x A (recommendation based on significant good quality literature containing 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) and 7x CCP (clinical consensus point).


CONCLUSIONS
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.
Klinik für Allgemein- und Visceralchirurgie, Klinikum St. Georg gGmbH, Delitzscher Str. 141, 04129, Leipzig, Deutschland, Arved.Weimann@sanktgeorg.de.
A
A
Weimann
S
S
Breitenstein
J P
JP
Breuer
S E
SE
Gabor
S
S
Holland-Cunz
M
M
Kemen
F
F
Längle
N
N
Rayes
B
B
Reith
P
P
Rittler
W
W
Schwenk
M
M
Senkal
D004750:Enteral Nutrition / Q000379:methods*; D019317:Evidence-Based Medicine; D005526:Food, Formulated; D005858:Germany; D006801:Humans; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D010289:Parenteral Nutrition, Total / Q000379:methods*; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy*; D011502:Protein-Energy Malnutrition / Q000175:diagnosis / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012955:Societies, Medical