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Bedeutung der perioperativen Ernährungstherapie beim Risiko- und Komplikationsmanagement von Patienten mit Ösophaguskarzinom

Impact of perioperative nutritional therapy on risk and complication management in patients undergoing esophagectomy for cancer

Zusammenfassung

Die Ösophagusresektion zählt zu den Hochrisikoeingriffen und fällt deswegen in Deutschland unter die vom Gemeinsamen Bundesausschuss definierte Mindestmengenregelung. Zur Bedeutung der perioperativen Ernährungstherapie im Rahmen des Risiko- und Komplikationsmanagements erfolgt eine systematische Literaturübersicht unter Einbeziehung der aktuellen S3-Leitlinienempfehlungen und -kommentare der Arbeitsgemeinschaft Wissenschaftlich Medizinischer Fachgesellschaften (AWMF), an denen die Autoren selbst mitgewirkt haben.

Abstract

Esophagectomy is considered to be a high risk procedure regarding postoperative morbidity and mortality. Therefore, in Germany, these operations are limited to hospitals fulfilling a minimum quantity. This systematic review focuses on risk and complication management regarding the impact of perioperative nutritional therapy, including the recent S3-guideline recommendations and comments of the German Working Group of Medical Societies (AWMF) which were established with contributions from the authors.

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Abbreviations

ASPEN:

American Society for Parenteral and Enteral Nutrition

BIA:

Bioelektrische Impedanzanalyse

BMI:

Body Mass Index = Körpermassenindex

CT:

Computertomografie

EK:

Expertenkonsens

ERAS:

Enhanced Recovery After Surgery

ESPEN:

European Society for Clinical Nutrition and Metabolism

FKJ:

Feinnadelkatheterjejunostomie

HRQL:

Health Related Quality of Life

NRS:

Nutritional Risk Score

SGA:

Subjective Global Assessment

SMI:

Skelettmuskelindex

WHO:

World Health Organization

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Correspondence to A. Weimann M.A..

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Interessenkonflikt

A. Weimann erhielt für Vortragstätigkeiten Honorare mit Übernahme der Reisekosten durch folgende Firmen: Baxter Deutschland GmbH, B. Braun/Melsungen AG, Fresenius Kabi Deutschland GmbH, Nestlé HealthCare Nutrition GmbH, Nutricia GmbH, ferner Studienunterstützungen durch Baxter Deutschland GmbH und Danone. I. Gockel, A. Hölscher und H.-J. Meyer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Weimann, A., Gockel, I., Hölscher, A. et al. Bedeutung der perioperativen Ernährungstherapie beim Risiko- und Komplikationsmanagement von Patienten mit Ösophaguskarzinom. Chirurg 87, 1046–1053 (2016). https://doi.org/10.1007/s00104-016-0256-4

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Schlüsselwörter

  • Ösophaguskarzinom
  • Ösophagusresektion
  • Risikomanagement
  • Ernährungsstatus
  • Perioperative Ernährungstherapie

Keywords

  • Esophageal cancer
  • Esophagectomy
  • Risk management
  • Nutritional status
  • Perioperative nutritional therapy