title: Advances in clinical nutrition in GI surgery.
abstract: This review addresses recent relevant advances to clinical nutrition regarding gastrointestinal disease surgery. Medline Ovid, EMBASE and Central were searched systematically in April 2014. Inclusion criteria were randomized controlled trials, non-randomized controlled trials and observational studies evaluating nutritional support in gastrointestinal surgery published within 5 years. The review included 56 relevant studies. Themes were: nutrition screening and risk factors predict outcome; preoperative nutritional support; shortening fasting periods and including carbohydrate solutions; early nutrition after surgery; immune modulating nutrition; synbiotics, growth hormone, omega-3 and oral, enteral and parenteral nutrition in combination. Screening for nutritional risk is profound, with special focus on dietary intake in the past week. Age and severity of disease need to be included in the screening system. Patients at severe nutritional risk benefit from nutritional therapy before surgery. New standards are developing quickly and clinical guidelines on surgery should include updated knowledge within clinical nutrition.
authors.affiliation: Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital and Department of Health Sciences, Aalborg University, Mølleparkvej 4, 2, Reception 3, 9000 Aalborg, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Holst
authors.forename: Henrik H
authors.initials: HH
authors.lastname: Rasmussen
authors.forename: Oivind
authors.initials: O
authors.lastname: Irtun
mesh_terms: D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000639:trends; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015596:Nutrition Assessment; D009752:Nutritional Status; D018529:Nutritional Support / Q000379:methods* / Q000639:trends; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: advances; clinical outcome; clinical trails; enteric feeding; gastrointestinal; nutrition risk screening; patients; review; surgery; undernutrition