Moderne perioperative ernährungskonzepte bei elektiven kolonresektionen

Based on the promising results of multimodal rehabilitation (fast track surgery), it is reasonable to introduce novel concepts of perioperative nutrition in all patients undergoing colorectal surgery. In addition to shorter preoperative starving periods, an adequate screening for malnourished patients must be performed in the clinical routine to ensure preoperative optimization of the nutritional status. A safe and practical screening tool has been introduced with the so-called NRS 2002. In addition to optimized preoperative feeding concepts, it is just as well necessary to shorten the well-established prolonged periods of postoperative starving. This can be done by quickly introducing a patient-oriented postoperative enteral nutrition. This includes oral liquids on the day of surgery and enterai nutrition beginning on the 1st post-operative day. In patients with impaired gastrointestinal function a combined enterai and parenteral supply of calories should be considered. A total parenteral nutrition after colorectal surgery may only be necessary in patients with persistent postoperative bowel obstruction or relevant anastomotic leakage in the gastrointestinal tract.