Annals of Clinical Nutrition and Metabolism

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: 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.

14 View
0 Download

Changes in perceptions of taste after bariatric surgery: a narrative review: Young Suk Park; Ann Clin Nutr Metab 2024;16(3):120-124. Published online December 1, 2024; DOI: https://doi.org/10.15747/ACNM.2024.16.3.120

Abstract PDF: Purpose: Bariatric surgery effectively treats severe obesity, leading to significant weight loss and improved comorbidities. However, many patients experience postoperative alterations in taste perception, affecting food selection and eating behavior. This narrative review examines the current understanding of taste perception changes following bariatric surgery, including patterns, potential mechanisms, impact on weight loss outcomes, and implications for patient care.
Current concept: Changes in taste perception are frequently reported after bariatric procedures, with prevalence rates from 36% to 72%. Common alterations involve decreased preference and increased sensitivity to sweet and fatty tastes, potentially leading to reduced calorie intake and healthier food choices. Persistence of these changes varies and may depend on surgery type, with Roux-en-Y gastric bypass patients often experiencing more substantial effects than sleeve gastrectomy patients. Potential mechanisms include alterations in gut hormone secretion (e.g., GLP-1, peptide YY, ghrelin), modifications in neural pathways (e.g., vagus nerve), and shifts in the gut microbiome. These factors may collectively influence taste sensitivity and preferences, contributing to weight loss outcomes. Altered reward processing may reduce the appeal of high-calorie foods.
Conclusion: Alterations in taste perception are common after bariatric surgery and may significantly impact dietary behaviors, weight loss, and quality of life. While exact mechanisms are not fully understood, changes in gut hormones, neural pathways, and microbiota are likely involved. Patient counseling and postoperative management of bariatric surgery patients should address potential changes in taste. Further research is needed to elucidate the long-term impacts of taste alterations on weight-loss maintenance and nutritional status.

13 View
1 Download

The 2024 Korean Enhanced Recovery After Surgery guidelines for colorectal cancer: Kil-yong Lee, Soo Young Lee, Miyoung Choi, Moonjin Kim, Ji Hong Kim, Ju Myung Song, Seung Yoon Yang, In Jun Yang, Moon Suk Choi, Seung Rim Han, Eon Chul Han, Sang Hyun Hong, Do Joong Park, Sang-Jae Park, The Korean Enhanced Recovery After Surgery (ERAS) Committee within the Korean Society of Surgical Metabolism and Nutrition; Ann Clin Nutr Metab 2024;16(2):22-42. Published online August 1, 2024; DOI: https://doi.org/10.15747/ACNM.2024.16.2.22

Abstract PDF Supplementary Material: The Korean Enhanced Recovery After Surgery (ERAS) Committee within the Korean Society of Surgical Metabolism and Nutrition was established to develop ERAS guidelines tailored to the Korean context. This guideline focuses on creating the most current evidence-based practice guidelines for ERAS based on systematic reviews. All key questions targeted randomized controlled trials (RCTs) exclusively. If fewer than two RCTs were available, studies using propensity score matching were also included. Recommendations for each key question were marked with strength of recommendation and level of evidence following internal and external review processes by the committee.

67 View
5 Download

Comparative assessment of nutritional characteristics of critically ill patients at admission and discharge from the neurosurgical intensive care unit in Korea: a comparison study: Eunjoo Bae, Jinyoung Jang, Miyeon Kim, Seongsuk Kang, Kumhee Son, Taegon Kim, Hyunjung Lim; Ann Clin Nutr Metab 2023;15(3):97-108. Published online December 1, 2023; DOI: https://doi.org/10.15747/ACNM.2023.15.3.97

Abstract PDF: Purpose: Patients in neurosurgical (NS) intensive care units (ICUs) experience considerable energy and protein deficits associated with adverse outcomes. This study aimed to compare the nutritional status of patients at admission to (baseline) and discharge from the NS ICU.
Methods: This was a single-center, retrospective, before and after study of patients admitted in the NS ICU of the CHA Bundang Medical Center, from January 31, 2019, to February 28, 2020. All anthropometric data, biochemical data, clinical data, and dietary data were collected during the NS ICU stay. Specifically, we investigated the cumulative caloric deficit rate, phase angle and skeletal muscle index as indicators of lean muscle mass, and nitrogen balance according to demographic and clinical characteristics.
Results: A total of 140 NS patients were studied. Calf circumference decreased from 31.4±4.2 cm at baseline to 30.2±4.0 cm at discharge (P<0.001). Energy supply rate increased from 44.4% at baseline to 89.2% at discharge. Phase angle (PhA) patients with an modified Nutrition Risk in the Critically ill (mNUTRIC) score≤5 group had significantly lower PhA values than those with an mNUTRIC score>5 (P=0.005).
Conclusion: Although clinical and dietary parameters of patients in the NS ICU improved from baseline to discharge, anthropometric and biochemical markers of lean muscle mass and nutritional status decreased. PhA and nitrogen balance difference values were significantly different between those with an mNUTRIC score≤5 and those with an mNUTRIC score>5. These data indicate that the nutritional risk of critically ill patients increases during hospitalization in the NS ICU.

12 View
0 Download

Role of preoperative immunonutrition in patients with colorectal cancer: a narrative review: Soo Young Lee, Hyeung-min Park, Chang Hyun Kim, Hyeong Rok Kim; Ann Clin Nutr Metab 2023;15(2):46-50. Published online August 1, 2023; DOI: https://doi.org/10.15747/ACNM.2023.15.2.46

Abstract PDF: Purpose: Colorectal cancer surgery presents challenges due to surgical stress and immunosuppression, leading to postoperative complications. Nutrition is crucial for colorectal cancer patients who are prone to malnutrition. This study aims to provide a comprehensive review of the role of preoperative immunonutrition in colorectal cancer surgery.
Current concept: Preoperative immunonutrition, consisting of immunonutrients such as arginine, ω-3 fatty acids, and nucleotides, has emerged as a potential strategy to enhance surgical outcomes by modulating immune responses and reducing complications. Current guidelines recommend preoperative oral nutritional supplements for major abdominal surgery and immunonutrition for nutritionally high-risk patients. Meta-analysis have demonstrated significant decreases in infectious complications and hospital stay durations with preoperative immunonutrition. However, limitations such as publication bias and heterogeneity in the previous studies should be considered. Further research should focus on the optimal timing, duration, and amount of immunonutrition; the patient populations that would benefit most; and the integration of immunonutrition into enhanced recovery after surgery protocols.
Conclusion: While preoperative immunonutrition shows promise, additional research is crucial to refine protocols and establish optimal clinical practice utilization.

14 View
1 Download

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: 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.

7 View
0 Download

Effect of Probiotics/Synbiotics on Postoperative Outcomes in Patients Undergoing Abdominal Surgery: In Ja Park; Ann Clin Nutr Metab 2022;14(1):10-19. Published online June 1, 2022; DOI: https://doi.org/10.15747/ACNM.2022.14.1.10

Abstract PDF: Environmental factors, drugs, diet, and surgery alter the composition of the gut microbiota leading to the production of different metabolites or toxins that can cause disease or delay postoperative recovery. Surgical damage leads to gut barrier disruption, increased intestinal permeability, gut microbial imbalance, and immunologic compromise of the host with subsequent bacterial translocation from the gastrointestinal tract to systemic circulation. Therefore, perioperative stabilization of the intestinal microbiota is a potential method of reducing postoperative complication rates. Probiotics have been proposed as a viable option for prophylaxis of postoperative infections through increased intestinal motility to prevent bacterial overgrowth, improve gut barrier function, and modulate immune response. This review investigates microbial changes after surgery and the influence of probiotics on postoperative microbial composition. Infectious postoperative complications and immunologic changes related to probiotics/synbiotics were also reviewed in patients who underwent abdominal surgery.

44 View
3 Download

Perioperative Management of Morbidly Obese Patients during Major Abdominal Surgery: Byeong-Gon Na, Sang-Jae Park; Ann Clin Nutr Metab 2021;13(2):26-33. Published online December 31, 2021; DOI: https://doi.org/10.15747/ACNM.2021.13.2.26

Abstract PDF: The population with obesity is seeing a steady increase globally. Obesity is known to be associated with morbidity and mortality after major abdominal surgery, and this correlation becomes more prominent in morbidly obese (MO) patients. Accordingly, adequate preoperative evaluation and preparation should be performed with an understanding of the pathophysiological changes associated with the MO. Precise surgery and adequate postoperative management are also mandatory to reduce complications and unplanned readmissions. However, adequate guidelines for the perioperative management of MO patients undergoing major abdominal surgery are lacking. We provide an overview of the pathophysiologic changes and practical guidelines on the perioperative management of major abdominal surgery in MO patients.

19 View
1 Download

Nutritional Status of Patients with Hepatobiliary-Pancreatic Surgical Disease: Sang Soo Eom, Yong Chan Shin, Chang-Sup Lim, In Woong Han, Woohyun Jung, Yoonhyeong Byun, Dong Wook Choi, Jin Seok Heo, Hongbeom Kim; Surg Metab Nutr 2020;11(2):46-52. Published online December 30, 2020; DOI: https://doi.org/10.18858/smn.2020.11.2.46

Abstract PDF: Purpose: This study examined the nutritional status of patients with hepatobiliary-pancreatic diseases before surgery to establish basic reference data.
Materials and Methods: This study evaluated retrospectively 2,322 patients admitted for hepatobiliary-pancreatic surgery between 2014 and 2016 at four Korean medical institutions using the body mass index (BMI) score. The prognostic nutrition index (PNI) was calculated in patients diagnosed with malignant diseases.
Results: The mean BMI was 24.0 kg/m² (range, 13.2~39.1 kg/m²). The patients were classified as low BMI (<21.5 kg/ m², below 25 percentile), intermediate BMI (21.5~25.5 kg/m²), and high BMI (>25.5 kg/m², above 75 percentile). There were significant differences in the age, sex distribution, ASA classification, type of hospitalization, biliary drainage, organ, and pathology diagnosis between the pairs among the low, intermediate, and high BMI groups. Among the three BMI groups, the complication rate of the low BMI group was highest (34.4% vs. 29.7% vs. 25.8% P=0.005). The median lengths of hospital stay in the low, intermediate, and high BMI groups were 9, 9, and 7 days, respectively (P<0.001). Multivariate analysis revealed the risk factors of the low BMI group to be a higher ASA classification, biliary drainage, pancreatic disease, and malignant disease. The group with PNI<45 had significantly longer hospital stays than the group with PNI≥45 (P<0.001).
Conclusion: Patients with a low BMI had a higher ASA classification, preoperative biliary drainage, pancreatic disease, and malignant disease. The low PNI group had significantly longer hospital stays than the high PNI group. Screening of the preoperative nutritional status is necessary for assessing the risk of malnutrition and its treatment.

6 View
0 Download

Status of Nutritional Support after Emergency Gastrointestinal Surgery in Korea: Retrospective Multicenter Study: Dae Sang Lee, Young Eun Park, Kyoung Hoon Lim, Ye Rim Chang, Suk-Kyung Hong, Minchang Kang, Jung-Min Bae, Ji Young Jang, Young Goun Jo, Ki Hoon Kim, Gil Jae Lee; Surg Metab Nutr 2020;11(1):1-6. Published online June 30, 2020; DOI: https://doi.org/10.18858/smn.2020.11.1.1

Abstract PDF: Purpose: Surgery itself causes an inflammatory response to an injury to the patient that leads to a stress metabolic state. Emergency gastrointestinal surgery may cause complications, such as ileus, bowel obstruction, ischemia, or anastomotic leakage, resulting in a delayed oral diet or poor overall nutrition. This study investigated the route of nutrition for patients who underwent emergency gastrointestinal surgery and when to provide nutrition after surgery.
Materials and Methods: Ten hospitals collected data retrospectively on the nutritional status and nutritional status of patients undergoing emergency gastrointestinal surgery for one year from January to December 2016. The clinical outcomes of the nutrient supply method, duration of supply, and type of surgery were performed. The dates from the time of surgery to the start of enteral nutrition, oral nutrition, and parenteral nutrition were calculated.
Results: Of 706 patients, there were 187 (26.5%) trauma patients, of which 63.5% were male. The onset of nutrition began after an average of 10.7 days postoperatively and after an average of 12.1 days of enteral nutrition. On average, it took 7.7 days to provide adequate calories, of which 63.3% had achieved adequate calories within a week. In the case of minimally invasive surgery, such as laparoscopic surgery, the adequate calorie supply time was five days, which was reached within one week.
Conclusion: In a retrospective multicenter analysis, the patients who underwent emergency gastrointestinal surgery had a late start of oral or enteral nutrition, and the ratio of adequate calorie supply within a week was low.

6 View
0 Download

Survey and Analysis of the Application and Implementations of Enhanced Recovery after Surgery (ERAS) Program for Surgical Patients in the Major Hospitals in Korea: Eun Young Kim, In Kyu Lee; Surg Metab Nutr 2019;10(2):32-45. Published online December 30, 2019; DOI: https://doi.org/10.18858/smn.2019.10.2.32

Abstract PDF: Purpose:

A questionnaire survey was conducted using e-mail to investigate the application status of ERAS in Korea and its implementation by their institution. The perceptions of ERAS by medical staff and the factors that interfered with the application of ERAS were investigated.

Materials and Methods:

From July 2017 to March 2019, a questionnaire was sent by e-mail to members of the KSSMN. This consisted of 41 questions divided into three parts to investigate 1) respondents’ prior knowledge and understanding of ERAS, 2) actual components of ERAS and its clinical application, and 3) performance and preference of the respondents to ERAS. The items were categorized into “high acceptance” when more than 75% of respondents answered “yes”, or the items into “low acceptance” when less than 25% answered “no”.

Results:

Overall, 86 participants completed the survey. Of these, 59(68.6%) had prior knowledge of ERAS and 29 (33.7%) applied ERAS clinically. Seventy (81.4%) and 40 (46.5%) answered that ERAS would have a positive effect on shortening the hospital stay and reducing the number of complications. Seventy four (86%) indicated that they would implement ERAS in the future. The factors impeding the implementation of ERAS were a lack of understanding of physicians and a shortage of manpower and resources for ERAS.

Conclusion:

The ERAS implementation rate and awareness level of surgeons were low, but the positive expectations of the clinical efficacy of ERAS and the wiliness to accept were high. Overall, it would be necessary to cooperate with institutions to improve the manpower and resources, and supplement the education to overcome the lack of awareness, which has been pointed out as an obstacle to the implementation of ERAS.

9 View
0 Download

Major Surgery in Sarcopenic Patients: Kyung Won Seo; Surg Metab Nutr 2019;10(1):5-8. Published online June 30, 2019; DOI: https://doi.org/10.18858/smn.2019.10.1.5

Abstract PDF: Sarcopenia refers to reduced muscle mass in the elderly population, and this malady is of great interest in clinical course, including postoperative complications and mortality when treating major cancer in the elderly. The definition of sarcopenia varies according to the method of measuring muscle mass, and the skeletal muscle index (SMI) tends to be extensively used in retrospective studies. In many reports, sarcopenia has been reported to be a poor prognostic factor after gastrectomy, colectomy, pancreatectomy and liver transplantation, with regards to complications and the length of the hospital stay. Additionally, patients suffering from sarcopenia have a higher medical burden due to their poor clinical outcome after surgery. To overcome these difficulties, nutritional support and exercise training to improve sarcopenia before surgery is helpful, and so further studies that focus on these treatments need to be conducted.

6 View
0 Download

Nutritional Assessment of Critically Ill Patients after Abdominal Surgery and Predisposing Factors of Prolonged ICU Stay after Surgery: Sung Eun Park, In Kyu Lee, Eun Young Kim; Surg Metab Nutr 2018;9(2):68-74. Published online December 30, 2018; DOI: https://doi.org/10.18858/smn.2018.9.2.68

Abstract PDF: Purpose:

Patients in prolonged intensive care unit stay were vulnerable to malnutrition which deteriorated recovery and postoperative outcomes. The purpose of this study was to evaluate nutritional status in surgical patients entering the intensive care unit, and to identify the risk factors that influence prolonged intensive care unit stay.

Materials and Methods:

From January 2016 to June 2018, 740 patients (age≥18 years) who were admitted to our surgical intensive care unit after abdominal surgery with general anesthesia (≥4 hours) were enrolled. Patients were classified into short-term stay group (≤4 days) and long-term stay group (>4 days). These groups were analyzed and compared with patient factors and postoperative outcomes and the multivariate analysis was performed to assess the risk factors for prolonged intensive care unit stay.

Results:

A total of 119 patients were analyzed. The univariate and multivariate analysis showed that dialysis status (Odds ratio 7.684, 95% confidence interval 1.038∼1.103, P=0.013), total lymphocyte count (Odds ratio 0.999, 95% confidence interval 0.998∼1.000, P=0.047), and intraoperative transfusion (Odds ratio 1.002, 95% confidence interval 1.001∼1.002, P=0.000) were associated with prolonged intensive care unit stay. Lone-term stay group were significantly longer hospital stay and higher hospital morbidity rate than short-term stay group.

Conclusion:

Patients with risk factors of prolonged intensive care unit stay included dialysis status, low total lymphocyte count, a large amount of transfusion would be more interested and the active intervention such as early nutritional evaluation and adequate nutritional support should be needed.

6 View
0 Download

Is Postoperative Albumin Level Related with Surgical Site Infection?: Kyungtae CHO, Sung Woo CHO, Sangchul YUN, Suyeon Park; Surg Metab Nutr 2018;9(2):59-67. Published online December 30, 2018; DOI: https://doi.org/10.18858/smn.2018.9.2.59

Abstract PDF: Purpose:

Surgical site infection (SSI) is a hospital-acquired infection (HAI) associated with increased mortality, length of hospital stay, and cost of hospitalization. The aim of this study was to identify the value of albumin as an indicator of the nutritional status, postoperative C-reactive protein (CRP), and white blood cell (WBC) levels in predicting an outbreak of SSI and SSI-related epidemiology after colorectal surgery and identifying the risk factors for SSI.

Materials and Methods:

A total of 198 patients, who underwent colorectal surgery from September 1, 2015 to December 31, 2016, were included in the study. The patient identity, operation characteristics, and SSI data were analyzed retrospectively by a chart review and national SSI reporting sheet. The relationship of the SSI and clinical data was analyzed statistically, and the SSI detection time and post-operative inflammatory laboratory findings were analyzed individually using cumulative incidence analysis and cause-specific hazard model.

Results:

The incidence of SSI post colorectal surgery was 15.7% (31 out of 198 cases). Chronic renal failure (CRF), open surgery, long operation time, and stoma were identified as significant risk factors for SSI using univariate analysis. The CRF, long operation time, and stoma were significant risk factors according to multivariate analysis. The decrease in albumin on post-operative day (POD)#3 and CRP elevation on POD#4 were related to the early detection of SSI.

Conclusion:

The actual incidence of SSI might be higher than expected, particularly in cases where patients have several clinical and operative factors. In addition, the albumin level and multiple postoperative inflammation tests can be employed as an early predictors of SSI.

8 View
0 Download

Incidence and Management of Micronutrient Deficiencies in Post-bariatric Surgery Patients: Young Suk Park, Ki Bum Park, Sa-Hong Min, Yoontaek Lee, Sang-Hoon Ahn, Do Joong Park, Hyung-Ho Kim; J Clin Nutr 2017;9(2):48-55. Published online December 31, 2017; DOI: https://doi.org/10.15747/jcn.2017.9.2.48

Abstract PDF: Bariatric surgery is considered one of the most effective methods of achieving long-term weight loss in morbidly obese patients. Nevertheless, bariatric procedures are associated with a number of complications, and nutrient deficiencies can lead to deleterious consequences. Furthermore, the diet of patients prior to bariatric surgery is often of poor nutrition quality that does not meet the recommended dietary guidelines for micronutrient intake. Therefore, optimization of the postoperative nutritional status should begin before surgery. This review covers the essential information about micronutrient management in patients before and after bariatric surgery.

5 View
0 Download

Micronutrients Deficiencies in Bariatric Patients: Yeon Ji Lee; Surg Metab Nutr 2016;7(1):7-12. Published online June 30, 2016; DOI: https://doi.org/10.18858/smn.2016.7.1.7

Abstract PDF: Paradoxically, the obese are more susceptible to malnutrition. The more obese they are, the greater the risk for micronutrient deficiencies particularly in fat-soluble vitamins and anti-oxidants. Several micronutrient deficiencies could be worsened because of poor intake and absorption difficulty after bariatric surgery. Micronutrient deficiencies could not only decrease the effect of bariatric surgery but also cause various diseases such as anemia, neurologic impairment, or osteoporosis. Micronutrient deficiencies should be monitored, recognized, and corrected properly in bariatric patients in order to maximize the effect of surgery and improve the health-related quality of life.

6 View
0 Download

Pilot Study for Safety and Efficacy of Newly Developed Oral Carbohydrate-Rich Solution Administration in Adult Surgery Patients: Won-Bae Chang, Kyuwhan Jung, Sang-Hoon Ahn, Heung-Gwon Oh, Mi-Ok Yoon; J Clin Nutr 2016;8(1):24-28. Published online April 30, 2016; DOI: https://doi.org/10.15747/jcn.2016.8.1.24

Abstract PDF: Purpose:
In surgical procedures under general anesthesia, 6 to 8 hours of a nulla per os (NPO; nothing by mouth) has been regarded as essential for prevention of respiratory complication such as aspiration. However, recent studies have reported that oral intake of water and other clear fluids up to 2 hours before induction of anesthesia does not increase respiratory problems. The purpose of this pilot study is to investigate the safety and efficacy of a newly developed carbohydrate-rich solution in elective hernia repair surgery patients.
Methods:
A group of 30 adult patients scheduled for elective surgeries under general anesthesia were enrolled. The enrolled study group of patients was permitted to drink a carbohydrate-rich solution until two hours before the operation without volume limitation. Respiratory complication was investigated in the patients using the carbohydrate-rich solution until two hours before induction of general anesthesia. The feelings of thirst, hunger sense were measured pre- and post-operatively. In addition, hoarseness of voice, nausea and vomiting were investigated post-operatively. Satisfaction regarding the short time of fasting was measured. Visual analogue scale (VAS) was used for measurement of these six variables.
Results:
No patients showed serious respiratory complication such as dyspnea, desaturation. Eight of 30 study group patients complained of mild hoarseness. Most symptoms of hoarseness were mild, with VAS score less than 3 out of 10. Two patients complained 5 out of 10. Six patients felt nausea and 1 patient had vomiting. Pre/post-operative hunger sense and thirst feeling were 1.63/1.60 and 1.90/5.76, respectively. The satisfaction score was 3.00 out of 4.
Conclusion:
Allowing the administration of an oral carbohydrate-rich solution in elective surgery patients requiring general anesthesia is safe without serious respiratory complications and effective in providing satisfaction.

6 View
0 Download

Enhanced Recovery After Surgery is Feasible in Laparoscopic Low Anterior Resection for Rectal Cancer: Jeong Seon Jo, Soo Young Lee, Hun Jin Kim, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim; Surg Metab Nutr 2015;6(1):11-15. Published online June 30, 2015; DOI: https://doi.org/10.18858/smn.2015.6.1.11

Abstract PDF: Purpose:
The aim of this study was to compare short-term outcomes in patients who underwent laparoscopic assisted low anterior resection for colorectal cancer. The patients received either conventional perioperative care or the Enhanced Recovery After Surgery (ERAS) procedural care.
Materials and Methods:
A retrospective review was conducted in patients who underwent elective laparoscopic low anterior resection for colorectal cancer between May, 2011 and December, 2013. Patients were grouped and analyzed according to the perioperative care program of ERAS and conventional care.
Results:
A total of 81 patients received care via the ERAS pathway and 230 patients received care via conventional pathway. There was no significant difference in postoperative morbidity rates (P=0.381). The post-operative morbidity rates were 30.9% and 25.2% in the ERAS and conventional groups. No significant difference in hospital stay (9.0±6.8 vs. 8.6±3.5 days; P=0.575) was observed between the 2 groups.
Conclusion:
No short-term perioperative disadvantages were found for the ERAS program compared with the conventional perioperative care for colorectal cancer patients who underwent laparoscopic low anterior resection. (Surg Metab Nutr 2015;6:11-15)