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Current Approaches in Patient Nutrition During The Surgical Process

Yıl 2023, Cilt: 18 Sayı: 1, 183 - 190, 16.03.2023

Elife Kettaş Dölek Sevilay Erden

https://doi.org/10.17517/ksutfd.1034634
Cited By: 1

Öz

Surgical trauma initiates a catabolic process which threatens homeostasis with the response of neurohormonal stress which it creates. Resilience after surgical
trauma is related not only to technical surgical skills, but also to the patient’s metabolic condition and the provision of suitable nutritional support.
Nutrition, despite being important for resilience after surgery, is often overlooked in surgical patients. Hunger and surgical stress initiate a catabolic reaction,
which causes organ dysfunction, slower wound healing, postoperative infections and an increase in morbidity and mortality, a longer stay in hospital and
increased costs. Evidence-based correct nutrition supports positive patient outcomes in the prevention of complications related to nutrition in the perioperative
period. Ensuring correct nutrition of the patient by up-to-date approaches and evidence-based practices can allow a quicker postoperative recovery
by reducing catabolism and supporting anabolism. Nutrition of surgical patients requires a multidisciplinary team approach. Nurses, who have a key role in
the multidisciplinary team in reducing the surgical stress process, should optimally support the patient’s nutrition within the framework of current dietary
recommendations. The aim of this compilation was to emphasize the importance of nutrition management in patients undergoing surgical intervention, and
to set out current practices in correct nutrition in the perioperative period..

Anahtar Kelimeler

nutrition surgical trauma nurse Evidence based practice

Kaynakça

  • Bisch S, Nelson G, Altman A. Impact of nutrition on enhanced recovery after surgery (ERAS) in gynecologic oncology. Nutrients. 2019;11(5):1088.
  • Gillis C, Wischmeyer PE. Pre-operative nutrition and the elective surgical patient: Why, how and what? Anaesthesia. 2019;74(1):27-35.
  • Torgersen Z, Balters M. Perioperative Nutrition. Surg. Clin North Am. 2015;95(2):255-267.
  • Mareitte C. Immunonutrition. Journal of Visceral Surgery. 2016;152(1):1-2.
  • Weimann A, Braga M, Carli F, Higashiguchi T, Hübner M, Klek S et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017;36(3):623-650.
  • Gillis C, Carli F. Promoting perioperative metabolic and nutritional care. Anesthesiology. 2015;123(6):1455-1472.
  • Wischmeyer PE, Carli F, Evans DC, Guilbert S, Kozar R, Pryor A, et al. Perioperative quality ınitiative (poqı) 2 workgroup. American society for enhanced recovery and perioperative quality ınitiative joint consensus statement on nutrition screening and therapy within a surgical enhanced recovery pathway. Anesth Analg. 2018;126(6):1883-1895.
  • Ali Abdelhamid Y, Chapman MJ, Deane AM. Peri-operative nutrition. Anaesthesia. 2016;71(1):9-18.
  • Lobo DN, Gianotti L, Adiamah A, Barazzoni R, Deutz NEP, Dhatariya K et al. Perioperative nutrition:Recommendations from the ESPEN expert group. Clin Nutr. 2020;39(11):3211-3227.
  • Gustafsson UO, Scott MJ, Nygren J, Hunber M, Demartines N, Francis N, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced recovery after surgery (eras®) society recommendations. World Journal of Surgery. 2019;43:659–695.
  • Williams D, Ohnuma T, Krishnamoorthy V, Raghunathan K, Sulo S, Cassady BA et al. Impact of early postoperative oral nutritional supplement utilization on clinical outcomes in colorectal surgery. Perioper Med. 2020;9:29.
  • Gündoğdu HR. Current approach to perioperative nutrition in the ERAS age. Clin Sci Nutr. 2019;1(1):1-10.
  • Yeung, SE, Hilkewich L, Gillis C, Heine JA, Fenton TR. Protein intakes are associated with reduced length of stay: A comparison between Enhanced Recovery After Surgery (ERAS) and conventional care after elective colorectal surgery. The American Journal of Clinical Nutrition. 2017;106(1):44-51.
  • Zhong JX, Kang K, Shu XL. Effect of nutritional support on clinical outcomes in perioperative malnourished patients: A meta-analysis. Asia Pac J Clin Nutr. 2015;24(3):367-378.
  • Aydoğan MS. Postoperatif dönemde beslenme. J Turgut Ozal Med Cent. 2015;22(4):274-275.
  • Kim JY, Wie GA, Cho YA, Kim SY, Sohn DK, Kim SK et al. Diet modification based on the enhanced recovery after surgery program (ERAS) in patients undergoing laparoscopic colorectal resection. Clin Nutr Res. 2018;7(4):297-302.
  • Martin L, Gillis C, Atkins M, Gillam M, Sheppard C, Buhler S et al. Implementation of an enhanced recovery after surgery program can change nutrition care practice: A multicenter experience in elective colorectal surgery. J Parenter Enteral Nutr. 2019;43(2):206-219.
  • Evans DC, Martindale RG, Kiraly LN, Jones CM. Nutrition optimization prior to surgery. Nutr Clin Pract. 2014;29(1):10-21.
  • Evans DC, Martindale RG, Kiraly LN, Jones CM. Nutrition optimization prior to surgery. Nutr Clin Pract. 2014;29(1):10-21.
  • Mc Clave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C et al. American society for parenteral and enteral nutrition. guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of critical care medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN. 2016;40(2):159-211.
  • Reber E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutritional risk screening and assessment. J Clin Med. 2019;8(7):1065.
  • Weimann A, Braga M, Carli F, Higashiguchi T, Hübner M, Klek S, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017;36(3):623-650.
  • Weimann A, Braga M, Carli F, Higashiguchi T, Hübner M, Klek S, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017;36(3):623-650.
  • Dou L, Wang X, Cao Y, Hu A, Li L. Relationship between postoperative recovery and nutrition risk screened by NRS 2002 and nutrition support status in patients with gastrointestinal cancer. Nutr Cancer. 2020;72(1):33-40.
  • Gillis C, Buhler K, Bresee L, Carli F, Gramlich L, Culos-Reed N, et al. Effects of nutritional prehabilitation, with and without exercise, on outcomes of patients who undergo colorectal surgery: A systematic review and meta-analysis. Gastroenterology. 2018;155(2):391-410.
  • Eti Aslan F, Turkurka Korkmaz E. Cerrahide Hızlandırılmış İyileşme Protokolleri. Ayfer Karadakovan, Fatma Eti Aslan. Dahili ve Cerrahi Hastalıklarda Bakım, 5. Baskı, Ankara, Akademisyen Kitapevi. 2020;223-231.
  • Gök F, Van Giersbergen Yavuz M. Ameliyat öncesi aç kalma: Sistematik derleme. Pamukkale Tıp Dergisi. 2018;11(2):183-194.
  • Zhang Z, Wang RK, Duan B, Cheng ZG, Wang E, Guo QL et al. Effects of a preoperative carbohydrate-rich drink before ambulatory surgery: A randomized controlled, double-blinded study. Med Sci Monit. 2020;26:e922837.
  • Ackerman RS, Tufts CW, DePinto DG, Chen J, Altshuler JR, Serdiuk A et al. How sweet is this? A review and evaluation of preoperative carbonhydrate loading in the enhanced recovery after surgery model. Nutr Clin Pract. 2020;35(2):246-253.
  • Abebe WA, Rukewe A, Bekele NA, Stoffel M, Mompelegi ND, Shifa JZ. Preoperative fasting times in elective surgical patients at a referral hospital in Botswana. Pan African Medical Journal. 2016;23(102):1-8.
  • Çakır Karaveli S, Van Giersbergen Yavuz M, Umar Çakır D. Cerrahi hemşirelerin ameliyat öncesi aç kalma ile ilgili uygulama ve bilgi düzeyi. Ege Üniversitesi Hemşirelik Fakültesi Dergisi. 2018;34(1):26-35.
  • Noba L, Wakefield A. Are carbohydrate drinks more effective than preoperative fasting: A systematic review of randomized controlled trials. J Clin Nurs. 2019;28 (17-18):3096-3116.
  • Gianotti L, Biffi R, Sandini M, Marrelli D, Vignali A, Caccialanza R et al. Preoperative oral carbohydrate load versus placebo in major elective abdominal surgery (PROCY): A randomized, placebo-controlled, multicenter, phase 3 trial. Ann Surg. 2018;267(4):623-630.
  • Şavluk ÖF, Kuşçu MA, Güzelmeriç F, Gürcü ME, Erkılınç A, Çevirme D et al. Do preoperative oral carbohydrates improve postoperative outcomes in patients undergoing coronary artery bypass grafts? Turk J Med Sci. 2017;19;47(6):1681-1686.
  • Liu B, Wang Y, Liu S, Zhao T, Zhao B, Jiang X, et al. A randomized controlled study of preoperative oral carbohydrate loading versus fasting in patients undergoing elective craniotomy, Clinical Nutrition. 2019;38(5):2106-2112.
  • Yazıcı G, Kayserilioğlu G. Cerrahi sonrası hızlandırılmış iyileşme protokolleri. Nermin Gürhan, Şengül Yaman Sözbir, Ülkü Polat Ü. Hemşirelik Alanında Kullanılan Kavram Beceri ve Modeller, Ankara, Nobel Tıp Kitapevleri, 2020;317-330.
  • Carmichael H, Joyce S, Smith T, Patton L, Lambert Wagner A, Wiktor AJ. Safety and efficacy of intraoperative gastric feeding during burn surgery. Burns. 2019;45(5):1089-1093.
  • Pham CH, Fang M, Vrouwe SQ, Kuza CM, Yenikomshian HA, Gillenwater J. Evaluating the safety and efficacy of ıntraoperative enteral nutrition in critically III burn patients: A systematic review and meta-analysis. J Burn Care Res. 2020;41(4):841-848.
  • Gündoğdu RH. Cerrahi İyileşmenin Hızlandırılması İçin Modern Teknikler. Fatma Eti Aslan. Cerrahi Bakım: Vaka Analizleri ile Birlikte, 2. Baskı, Ankara, Akademisyen Tıp Kitabevi, 2017;455-470.
  • Birlikbaşı S, Bölükbaş N. ERAS rehberi cerrahi sonrası hızlandırılmış iyileşme protokolleri. Ordu University J Nurs Stud. 2019;2(3):194-205.
  • Dağıstanlı S, Kalaycı MU, Kara Y. Genel cerrahide ERAS protokolünün değerlendirilmesi. İKSST. 2018;10:9-20.
  • Herbert G, Perry R, Andersen HK, Atkinson C, Penfold C, Lewis SJ, et al. Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications. Cochrane Database Syst Rev. 2019;7:CD004080.
  • Willcutts KF, Chung MC, Erenberg CL, Finn KL, Schirmer BD, Byham Gray LD. Early oral feeding as compared with traditional timing of oral feeding after upper gastrointestinal surgery: A systematic review and meta-analysis. Ann Surg. 2016;264(1):54-63.
  • Colebatch E, Lockwood C. Enhanced perioperative nutritional care for patients undergoing elective colorectal surgery at Calvary North Adelaide Hospital: A best practice implementation project. JBI Evid Synth. 2020;18(1):224-242.
  • Charoenkwan K, Matovinovic E. Early versus delayed oral fluids and food for reducing complications after major abdominal gynaecologic surgery. Cochrane Database Syst Rev. 2014;(12):CD004508.
  • Adiamah A, Lobo DN. Post-discharge oral nutritional supplementation after surgery for gastrointestinal cancer: Real or marginal gains? Clin Nutr. 2021;40(1):1-3.

Cerrahi Süreçte Hasta Beslenmesinde Güncel Yaklaşımlar

Yıl 2023, Cilt: 18 Sayı: 1, 183 - 190, 16.03.2023

Elife Kettaş Dölek Sevilay Erden

https://doi.org/10.17517/ksutfd.1034634
Cited By: 1

Öz

Cerrahi travma, oluşturduğu nörohormonal stres yanıtla homeostazı tehdit eden katabolik bir süreç başlatır. Cerrahi travma sonrası derlenme, yalnızca teknik
cerrahi becerilere değil, aynı zamanda hastanın metabolik durumunun ve uygun beslenme desteğinin sağlanmasına da bağlıdır. Beslenme, ameliyat sonrası
derlenme açısından önemli olmasına rağmen cerrahi hastalarda sıklıkla göz ardı edilmektedir. Açlık ve cerrahi stres, katabolik reaksiyonu başlatarak organ
disfonksiyonuna, yara iyileşmesinde gecikmeye, ameliyat sonrası enfeksiyonlara morbidite ve mortalite artışına, hastane yatışında uzamaya ve maliyet artışına
neden olmaktadır. Perioperatif süreçte beslenme ile ilişkili komplikasyonların önlenmesinde kanıt temelli doğru beslenme uygulamaları olumlu hasta
sonuçlarını desteklemektedir. Ameliyat sürecinde güncel yaklaşımlar ve kanıta dayalı uygulamalar ile hastanın doğru beslenmesi sağlanarak, katabolizmanın
azaltılması ve anabolizmanın desteklenmesi ile ameliyat sonrası daha hızlı bir iyileşme sağlanabilir. Cerrahi hastasının beslenmesi multidisipliner bir ekip
yaklaşımını gerektirir. Cerrahi stres sürecinin azaltılmasında multidisipliner ekipte anahtar rolü olan hemşireler, güncel beslenme önerileri çerçevesinde hastanın
beslenmesini optimal düzeyde desteklemelidirler. Bu derlemenin amacı, cerrahi girişim geçiren hastada beslenme yönetiminin önemini vurgulamak,
perioperatif süreçte doğru beslenmeyi güncel uygulamalarla ortaya koymaktır.

Anahtar Kelimeler

Beslenme cerrahi travma hemşire kanıt temelli uygulama

Kaynakça

  • Bisch S, Nelson G, Altman A. Impact of nutrition on enhanced recovery after surgery (ERAS) in gynecologic oncology. Nutrients. 2019;11(5):1088.
  • Gillis C, Wischmeyer PE. Pre-operative nutrition and the elective surgical patient: Why, how and what? Anaesthesia. 2019;74(1):27-35.
  • Torgersen Z, Balters M. Perioperative Nutrition. Surg. Clin North Am. 2015;95(2):255-267.
  • Mareitte C. Immunonutrition. Journal of Visceral Surgery. 2016;152(1):1-2.
  • Weimann A, Braga M, Carli F, Higashiguchi T, Hübner M, Klek S et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017;36(3):623-650.
  • Gillis C, Carli F. Promoting perioperative metabolic and nutritional care. Anesthesiology. 2015;123(6):1455-1472.
  • Wischmeyer PE, Carli F, Evans DC, Guilbert S, Kozar R, Pryor A, et al. Perioperative quality ınitiative (poqı) 2 workgroup. American society for enhanced recovery and perioperative quality ınitiative joint consensus statement on nutrition screening and therapy within a surgical enhanced recovery pathway. Anesth Analg. 2018;126(6):1883-1895.
  • Ali Abdelhamid Y, Chapman MJ, Deane AM. Peri-operative nutrition. Anaesthesia. 2016;71(1):9-18.
  • Lobo DN, Gianotti L, Adiamah A, Barazzoni R, Deutz NEP, Dhatariya K et al. Perioperative nutrition:Recommendations from the ESPEN expert group. Clin Nutr. 2020;39(11):3211-3227.
  • Gustafsson UO, Scott MJ, Nygren J, Hunber M, Demartines N, Francis N, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced recovery after surgery (eras®) society recommendations. World Journal of Surgery. 2019;43:659–695.
  • Williams D, Ohnuma T, Krishnamoorthy V, Raghunathan K, Sulo S, Cassady BA et al. Impact of early postoperative oral nutritional supplement utilization on clinical outcomes in colorectal surgery. Perioper Med. 2020;9:29.
  • Gündoğdu HR. Current approach to perioperative nutrition in the ERAS age. Clin Sci Nutr. 2019;1(1):1-10.
  • Yeung, SE, Hilkewich L, Gillis C, Heine JA, Fenton TR. Protein intakes are associated with reduced length of stay: A comparison between Enhanced Recovery After Surgery (ERAS) and conventional care after elective colorectal surgery. The American Journal of Clinical Nutrition. 2017;106(1):44-51.
  • Zhong JX, Kang K, Shu XL. Effect of nutritional support on clinical outcomes in perioperative malnourished patients: A meta-analysis. Asia Pac J Clin Nutr. 2015;24(3):367-378.
  • Aydoğan MS. Postoperatif dönemde beslenme. J Turgut Ozal Med Cent. 2015;22(4):274-275.
  • Kim JY, Wie GA, Cho YA, Kim SY, Sohn DK, Kim SK et al. Diet modification based on the enhanced recovery after surgery program (ERAS) in patients undergoing laparoscopic colorectal resection. Clin Nutr Res. 2018;7(4):297-302.
  • Martin L, Gillis C, Atkins M, Gillam M, Sheppard C, Buhler S et al. Implementation of an enhanced recovery after surgery program can change nutrition care practice: A multicenter experience in elective colorectal surgery. J Parenter Enteral Nutr. 2019;43(2):206-219.
  • Evans DC, Martindale RG, Kiraly LN, Jones CM. Nutrition optimization prior to surgery. Nutr Clin Pract. 2014;29(1):10-21.
  • Evans DC, Martindale RG, Kiraly LN, Jones CM. Nutrition optimization prior to surgery. Nutr Clin Pract. 2014;29(1):10-21.
  • Mc Clave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C et al. American society for parenteral and enteral nutrition. guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of critical care medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN. 2016;40(2):159-211.
  • Reber E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutritional risk screening and assessment. J Clin Med. 2019;8(7):1065.
  • Weimann A, Braga M, Carli F, Higashiguchi T, Hübner M, Klek S, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017;36(3):623-650.
  • Weimann A, Braga M, Carli F, Higashiguchi T, Hübner M, Klek S, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017;36(3):623-650.
  • Dou L, Wang X, Cao Y, Hu A, Li L. Relationship between postoperative recovery and nutrition risk screened by NRS 2002 and nutrition support status in patients with gastrointestinal cancer. Nutr Cancer. 2020;72(1):33-40.
  • Gillis C, Buhler K, Bresee L, Carli F, Gramlich L, Culos-Reed N, et al. Effects of nutritional prehabilitation, with and without exercise, on outcomes of patients who undergo colorectal surgery: A systematic review and meta-analysis. Gastroenterology. 2018;155(2):391-410.
  • Eti Aslan F, Turkurka Korkmaz E. Cerrahide Hızlandırılmış İyileşme Protokolleri. Ayfer Karadakovan, Fatma Eti Aslan. Dahili ve Cerrahi Hastalıklarda Bakım, 5. Baskı, Ankara, Akademisyen Kitapevi. 2020;223-231.
  • Gök F, Van Giersbergen Yavuz M. Ameliyat öncesi aç kalma: Sistematik derleme. Pamukkale Tıp Dergisi. 2018;11(2):183-194.
  • Zhang Z, Wang RK, Duan B, Cheng ZG, Wang E, Guo QL et al. Effects of a preoperative carbohydrate-rich drink before ambulatory surgery: A randomized controlled, double-blinded study. Med Sci Monit. 2020;26:e922837.
  • Ackerman RS, Tufts CW, DePinto DG, Chen J, Altshuler JR, Serdiuk A et al. How sweet is this? A review and evaluation of preoperative carbonhydrate loading in the enhanced recovery after surgery model. Nutr Clin Pract. 2020;35(2):246-253.
  • Abebe WA, Rukewe A, Bekele NA, Stoffel M, Mompelegi ND, Shifa JZ. Preoperative fasting times in elective surgical patients at a referral hospital in Botswana. Pan African Medical Journal. 2016;23(102):1-8.
  • Çakır Karaveli S, Van Giersbergen Yavuz M, Umar Çakır D. Cerrahi hemşirelerin ameliyat öncesi aç kalma ile ilgili uygulama ve bilgi düzeyi. Ege Üniversitesi Hemşirelik Fakültesi Dergisi. 2018;34(1):26-35.
  • Noba L, Wakefield A. Are carbohydrate drinks more effective than preoperative fasting: A systematic review of randomized controlled trials. J Clin Nurs. 2019;28 (17-18):3096-3116.
  • Gianotti L, Biffi R, Sandini M, Marrelli D, Vignali A, Caccialanza R et al. Preoperative oral carbohydrate load versus placebo in major elective abdominal surgery (PROCY): A randomized, placebo-controlled, multicenter, phase 3 trial. Ann Surg. 2018;267(4):623-630.
  • Şavluk ÖF, Kuşçu MA, Güzelmeriç F, Gürcü ME, Erkılınç A, Çevirme D et al. Do preoperative oral carbohydrates improve postoperative outcomes in patients undergoing coronary artery bypass grafts? Turk J Med Sci. 2017;19;47(6):1681-1686.
  • Liu B, Wang Y, Liu S, Zhao T, Zhao B, Jiang X, et al. A randomized controlled study of preoperative oral carbohydrate loading versus fasting in patients undergoing elective craniotomy, Clinical Nutrition. 2019;38(5):2106-2112.
  • Yazıcı G, Kayserilioğlu G. Cerrahi sonrası hızlandırılmış iyileşme protokolleri. Nermin Gürhan, Şengül Yaman Sözbir, Ülkü Polat Ü. Hemşirelik Alanında Kullanılan Kavram Beceri ve Modeller, Ankara, Nobel Tıp Kitapevleri, 2020;317-330.
  • Carmichael H, Joyce S, Smith T, Patton L, Lambert Wagner A, Wiktor AJ. Safety and efficacy of intraoperative gastric feeding during burn surgery. Burns. 2019;45(5):1089-1093.
  • Pham CH, Fang M, Vrouwe SQ, Kuza CM, Yenikomshian HA, Gillenwater J. Evaluating the safety and efficacy of ıntraoperative enteral nutrition in critically III burn patients: A systematic review and meta-analysis. J Burn Care Res. 2020;41(4):841-848.
  • Gündoğdu RH. Cerrahi İyileşmenin Hızlandırılması İçin Modern Teknikler. Fatma Eti Aslan. Cerrahi Bakım: Vaka Analizleri ile Birlikte, 2. Baskı, Ankara, Akademisyen Tıp Kitabevi, 2017;455-470.
  • Birlikbaşı S, Bölükbaş N. ERAS rehberi cerrahi sonrası hızlandırılmış iyileşme protokolleri. Ordu University J Nurs Stud. 2019;2(3):194-205.
  • Dağıstanlı S, Kalaycı MU, Kara Y. Genel cerrahide ERAS protokolünün değerlendirilmesi. İKSST. 2018;10:9-20.
  • Herbert G, Perry R, Andersen HK, Atkinson C, Penfold C, Lewis SJ, et al. Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications. Cochrane Database Syst Rev. 2019;7:CD004080.
  • Willcutts KF, Chung MC, Erenberg CL, Finn KL, Schirmer BD, Byham Gray LD. Early oral feeding as compared with traditional timing of oral feeding after upper gastrointestinal surgery: A systematic review and meta-analysis. Ann Surg. 2016;264(1):54-63.
  • Colebatch E, Lockwood C. Enhanced perioperative nutritional care for patients undergoing elective colorectal surgery at Calvary North Adelaide Hospital: A best practice implementation project. JBI Evid Synth. 2020;18(1):224-242.
  • Charoenkwan K, Matovinovic E. Early versus delayed oral fluids and food for reducing complications after major abdominal gynaecologic surgery. Cochrane Database Syst Rev. 2014;(12):CD004508.
  • Adiamah A, Lobo DN. Post-discharge oral nutritional supplementation after surgery for gastrointestinal cancer: Real or marginal gains? Clin Nutr. 2021;40(1):1-3.
Toplam 46 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derlemeler
Yazarlar

Elife Kettaş Dölek 0000-0002-1436-5620

Sevilay Erden 0000-0002-6519-864X

Yayımlanma Tarihi 16 Mart 2023
Gönderilme Tarihi 9 Aralık 2021
Kabul Tarihi 10 Mayıs 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 18 Sayı: 1

Kaynak Göster

AMA Kettaş Dölek E, Erden S. Cerrahi Süreçte Hasta Beslenmesinde Güncel Yaklaşımlar. KSÜ Tıp Fak Der. Mart 2023;18(1):183-190. doi:10.17517/ksutfd.1034634

Cited By

Ürolojik Cerrahi Hastasının Bakımında Güncel Yaklaşımlar
Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi
https://doi.org/10.51754/cusbed.1340627
 Kapak Resmi İndir