Annals of Clinical Nutrition and Metabolism

Heung-Kwon Oh

3 Articles

Perioperative nutritional practice of surgeons in Korea: a survey study: Ji-Hyeon Park, Mi Ran Jung, Sang Hyun Kim, Hongbeom Kim, Gyeongsil Lee, Jae-Seok Min, Heung-Kwon Oh, Jung Hoon Bae, Yoona Chung, Dong-Seok Han, Seung Wan Ryu, The External Relation Committee of the Korean Society of Surgical Metabolism and Nutrition; Ann Clin Nutr Metab 2024;16(3):134-148. Published online December 1, 2024; DOI: https://doi.org/10.15747/ACNM.2024.16.3.134

Abstract PDF Supplementary Material ePub: Purpose: Enhanced recovery after surgery (ERAS) protocols advocate reduced fasting and early nutrition to improve recovery in surgical patients. However, data on ERAS implementation among Korean surgeons performing major abdominal surgeries remain sparse.
Methods: A survey conducted by the External Relation Committee of the Korean Society of Surgical Metabolism and Nutrition assessed perioperative nutritional practices among 389 Korean general surgeons from February to September 2023. The survey covered preoperative fasting, carbohydrate drinks, nasogastric tube use, postoperative dietary progression, parenteral nutrition (PN), and oral supplements, yielding 551 responses stratified by specialty.
Results: More than 80% of respondents practiced “midnight NPO (Nil Per Os)” fasting, often at the anesthesiology department’s request, while 70%–80% reported no use of preoperative carbohydrate drinks. Most surgeons began dietary progression with water on postoperative day one, advancing to a liquid or soft diet by day two. PN was routinely prescribed by 49% of respondents, with a common dosage of 1,000–1,500 kcal/d. Oral supplements were selectively provided, with 21% of surgeons prescribing them universally.
Conclusion: The results reveal significant variability in perioperative nutrition practices across Korean surgical specialties, with many adhering to traditional practices despite ERAS guidelines. These findings highlight a need for standardized guidelines in Korea to optimize perioperative nutritional support and improve patient recovery outcomes following major abdominal surgeries.

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Development of the Korean Version of the Gastrointestinal Quality of Life Index Questionnaire: In Jun Yang, Heung-Kwon Oh, Jeehye Lee, Jung Wook Suh, Hong-min Ahn, Hyeonjeong Park, Hyun Hee Sim, Yong Beom Cho, In Kyu Lee, Seungbum Ryoo, Dong-Won Lee, Duck-Woo Kim, Sung-Bum Kang; Ann Clin Nutr Metab 2022;14(1):32-37. Published online June 1, 2022; DOI: https://doi.org/10.15747/ACNM.2022.14.1.32

Abstract PDF ePub

Purpose: To establish a standardized quality of life measurement that allows global cross-study comparisons, we translated the Gastrointestinal Quality of Life Index (GIQLI) into Korean and linguistically validated the Korean version of the GIQLI (K-GIQLI) in patients who underwent colorectal surgery.
Materials and Methods: A cross-cultural adaptation of the original GIQLI was created based on the established guidelines. Based on participation in a cognitive interview, 20 patients with colorectal cancer were enrolled in the study. To ensure that the Korean version of the questionnaire was understood as intended, the time needed to complete the questionnaire was measured, and three additional items related to comprehension were added.
Results: From May to July 2021, two translators, whose native language was Korean translated the GIQLI items into Korean, and a native English editor who had no knowledge of the original questionnaire translated the items back into English. In the cognitive interview, the median age of the patients was 61.8 (range: 44~82) years, and the median time required to complete the questionnaire was 6.5 (range: 5~10) min. For the language and cultural adaptation process, the participants’ comprehension of the questionnaire was measured on a scale of 1~5, with a mean score of 4 (range: 3~4).
Conclusion: The K-GIQLI was developed and did not exhibit a significant difference from the original English version in terms of social, linguistic, and cultural differences between the Western world and Republic of Korea.

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Longitudinal quality of life assessment after laparoscopic colorectal cancer surgery using the Gastrointestinal Quality of Life Index questionnaire: A multicentre prospective study
Tae‐Gyun Lee, Seung‐Bum Ryoo, Heung‐Kwon Oh, Yong Beom Cho, Chang Hyun Kim, Ju Hyun Lee, Hong‐Min Ahn, Hye‐Rim Shin, Mi Jeong Choi, Min Hyeong Jo, Duck‐Woo Kim, Sung‐Bum Kang
Colorectal Disease.2025;[Epub] CrossRef

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The Evaluation of Preoperative Oral Carbohydrate-Rich Solution Effects on Insulin Resistance in Patients undergoing Colectomy: Cherry Ann Sio, Kyuwhan Jung, Seong-Bum Kang, Duk-Woo Kim, Heung-Kwon Oh, Miok Yoon; J Clin Nutr 2015;7(2):62-67. Published online August 31, 2015; DOI: https://doi.org/10.15747/jcn.2015.7.2.62

Abstract PDF ePub

Purpose:

Reducing preoperative fasting time showed positive effects in several studies, and current guidelines suggest use of a preoperative oral carbohydrate-rich solution before elective surgeries. For elective colectomy procedures, some surgeons favor two-day bowel preparation with diet restriction and administration of laxatives. Aside from patients experiencing the discomfort of nil per os (NPO), there are reported benefits regarding intake of liquids until at least two hours prior to surgery, including decrease in insulin resistance, without additional postoperative surgical complications. The aim of this study is to show the benefits of administration of oral rehydration solution (ORS) two hours prior to surgery for patients undergoing elective colectomy, particularly postoperative insulin resistance.

Methods:

This is a randomized controlled trial. All patients undergoing elective colectomy were included and randomized to the control arm or treatment arm. The control arm consisted of the standard bowel preparation and one day of NPO, while the treatment arm consisted of the standard bowel preparation and allowing intake of carbohydrate-rich ORS until 2 hours before surgery. The insulin, glucose, cortisol, and triglyceride levels were determined immediately after induction, 6 hours, 24 hours, and 48 hours post-op, and compared. The homeostatic model assessment-insulin resistance, insulin, glucose, cortisol, and triglyceride levels were determined and compared between the two groups. Anxiety and postoperative complications were monitored and assessed as well.

Results:

There was less insulin resistance in patients who received ORS 2 hours prior to surgery. Insulin, glucose, cortisol, and triglyceride levels were lower in the treatment group compared to the control group. Taking ORS 1 day prior and until 2 hours before surgery decreased anxiety and discomfort, and alleviated hunger.

Conclusion:

Regarding complications, there was no difference in the incidence of aspiration and postoperative complications. There were fewer wound complications and incidence of paralytic ileus in the treatment group.