Transdisciplinary Management of Perioperative Nutrition

Colorectal surgery patients are at risk of malnutrition due to a multitude of factors including poor intake secondary to intestinal obstruction or cancer-associated anorexia, impaired absorption in inflammatory bowel disease, excessive losses from intestinal fistulas, and a marked inflammatory response in the setting of sepsis from perforated diverticulitis or tumor. The influence of malnutrition on surgical outcomes has been increasingly recognized since 1939, when Studley first reported on the association between preoperative weight loss and mortality in surgical patients (Studley 1936). Improvements in research methodology and refinement of therapeutic methods have led to the establishment of internationally accepted clinical guidelines on nutrition therapy from the European Society for Clinical Nutrition and Metabolism (ESPEN) and the American Society for Parenteral and Enteral Nutrition (ASPEN). In the era of modern colorectal surgery, optimization of the patient’s nutritional status plays an important role in improving the results of surgical intervention. This chapter will provide an overview on the nutritional management of the colorectal surgery patient.