Indications and effects of preoperative parenteral nutrition

Abstract Malnutrition can be an important risk factor, especially in patients undergoing major gastrointestinal surgery. With 7–10 days of adequate preoperative parenteral nutrition, we are able to improve the nutritional status of most patients. Concentrations of several parameters of the protein compartment and immunocompetence increase significantly. The effect of preoperative parenteral nutrition on postoperative outcome has been tested in only a few properly designed comparative trials. The results were not unanimous. If the postoperative complication rate was high, preoperative parenteral nutrition significantly reduced it. Improvement in surgical technique limited the value of preoperative parenteral nutrition. However, as long as the postoperative complication rate is not zero, preoperative parenteral nutrition is indicated, especially in patients with cancer of the upper gastrointestinal tract, when a major operation is planned .