Subject(s)
Bronchogenic Cyst/surgery , Esophageal Cyst/surgery , Mediastinal Cyst/etiology , Mediastinal Cyst/surgery , Abdominal Pain/diagnostic imaging , Abdominal Pain/etiology , Abdominal Pain/surgery , Back Pain/diagnostic imaging , Back Pain/etiology , Back Pain/surgery , Bronchogenic Cyst/diagnostic imaging , Deglutition Disorders/diagnostic imaging , Deglutition Disorders/etiology , Deglutition Disorders/surgery , Diagnosis, Differential , Esophageal Cyst/diagnostic imaging , Female , Humans , Mediastinal Cyst/diagnostic imaging , Middle Aged , Multidetector Computed Tomography , Pulmonary Atelectasis/diagnostic imaging , Pulmonary Atelectasis/etiology , ThoracotomyABSTRACT
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. RESULTS AND DISCUSSION: 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). CONCLUSION: 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.