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Perioperative enterale und parenterale Ernährung bei Tumorpatienten

Perioperative enteral and parenteral nutrition in cancer patients

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Forum Aims and scope

Zusammenfassung

Hintergrund

Bei Tumorpatienten sollte vor großen Operationen ein besonderes metabolisches Risiko berücksichtigt werden. Die vorliegende Arbeit bezieht sich auf aktuelle S3-Leitlinienempfehlungen.

Methoden

Die frühzeitige Erkennung und Beobachtung von Patienten mit Gewichtsverlust und eingeschränkter oraler Nahrungsaufnahme ist essenziell. Mit dem Ziel der raschen Rekonvaleszenz und Verminderung der postoperativen Morbidität bedarf es innerhalb des ERAS-Konzepts („enhanced recovery after surgery“) auch besonderer metabolisch ernährungsmedizinischer Mitbetreuung. Wann immer möglich, sollte eine künstliche Ernährung vermieden werden. Wenn bei einem Risikopatienten eine längerfristige inadäquate orale Nahrungsaufnahme (> 10 Tage) vorhersehbar ist, sollte frühzeitig mit einer enteralen Supplementierung evtl. kombiniert parenteral begonnen werden. Eine vollständige langzeitparenterale Ernährung bleibt nur speziellen Indikationen vorbehalten.

Abstract

Background

In cancer patients scheduled to undergo major surgery a special metabolic risk for complications has to be taken into account. This review refers to recent S3 guideline recommendations.

Methods

Early detection and observation of patients with weight loss and diminished oral food intake before hospital admission remains an essential part of perioperative management. Aiming for enhanced recovery after surgery and reduction of postoperative morbidity (ERAS concept), there is a need for appropriate perioperative nutritional and metabolic care. Whenever possible, artificial nutritional support should be avoided; however, if inadequate oral intake has to be anticipated (> 10 days) in risk patients, nutritional support should be started early via the enteral route, possibly in combination with parenteral nutrition. Total long-term parenteral nutrition should be limited to special indications.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. A. Weimann erhielt Honorare für Vorträge von Abbott GmbH, Baxter Deutschland GmbH, B. Braun Melsungen AG, Fresenius-Kabi Deutschland GmbH, Nestlé HealthCare Nutrition GmbH, Nutricia GmbH sowie Forschungsunterstützung von Danone. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik für Allgemein- und Visceralchirurgie mit Abteilung Klinische Ernährung, Klinikum St. Georg Leipzig gGmbH, Delitzscher Str. 141, 04129, Leipzig, Deutschland

    A. Weimann M.A.

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Weimann, A. Perioperative enterale und parenterale Ernährung bei Tumorpatienten. Forum 29, 386–391 (2014). https://doi.org/10.1007/s12312-014-1177-0

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  • DOI: https://doi.org/10.1007/s12312-014-1177-0

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