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.

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Perioperative nutritional practices and attitudes among gastrointestinal oncologic surgeons in Korea: a nation-wide survey study: Dae Hoon Kim, Jeong-Meen Seo, Min-Gew Choi; Ann Clin Nutr Metab 2023;15(3):81-87. Published online December 1, 2023; DOI: https://doi.org/10.15747/ACNM.2023.15.3.81

Abstract PDF Supplementary Material: Purpose: This study aimed to investigate the current perioperative nutritional practices and attitudes among gastrointestinal (GI) oncologic surgeons in Korea. Evidence-based perioperative nutritional practices are not well-established in this field.
Methods: A nationwide survey was conducted with 24 items, targeting GI oncologic surgical faculty members from March 2022 to April 2022 through social networking service messaging and email. Whole target number was 3,421.
Results: Out of responding 161 GI surgeons, 83.9% were male and 16.1% were female, and about 49.7% were in their 40s. When asked about their hospital policies, 67.1% reported the existence of formal nutritional screening programs. However, the execution and analysis of these programs varied considerably. Most surgeons conducted preoperative nutritional screening, with albumin testing the most frequently performed. In addition, nutritional supplementation—primarily protein drinks—was given before surgery. The duration for which these supplements were used varied from ≤3 days to 4–7 days. Most respondents recognized the importance of addressing nutritional deficiencies in patients with GI tumors; however, when asked about immunonutrition, 89.4% of surgeons admitted having limited knowledge.
Conclusion: Although there is recognition of the importance of evidence-based nutrition practices in GI and oncologic surgery programs, this study reveals limited implementation of such practices. This study highlights a considerable opportunity to leverage existing positive surgeon beliefs and published data on the benefits of perioperative nutrition to enhance surgical nutrition practices and to improve patient outcomes in Korea.

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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: 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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Survey on the State of Nutrition Support Team (NST) Activity: Comparison of the Questionnaire Survey 2016 vs. 2005 and the State of NST Activity since the Introduction of the Medical Insurance Fee: Ji-Yoon Cho, Jung-Tae Kim, Seoung-Lan Kim; J Clin Nutr 2016;8(2):38-44. Published online August 31, 2016; DOI: https://doi.org/10.15747/jcn.2016.8.2.38

Abstract PDF: The Korean Society of Health-System Pharmacists (KSHP) and Korean Society for Parenteral and Enteral Nutrition (KSPEN) jointly performed a nation-wide questionnaire survey on the current state of Nutrition Support Team (NST) activity from March to May of 2016. The aim of the survey was to suggest ways to develop NST as well as to improve the relationship between the KSHP and KSPEN. Compared to the results of the 2005 survey, some progress was made in the activity of NST over the last decade. Not only was the activity of NST settled, but quantitative and qualitative growth was also achieved by activating rounds and regular meeting. On the other hand, the ratio of hospitals providing home care services has decreased. Therefore, further effort is needed for their revitalization.

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