ABSTRACT
In patients with colorectal disease, optimization of nutritional well-being is critical in achieving a high-quality surgical outcome. Patients’ immune status and physiological response to illness and surgical insult are intrinsically linked with their nutritional health (Braga et al. 1999). Most centers are mindful of optimizing patients’ perioperative nutrition with the goal of minimizing surgical complications, in particular infectious problems (Bozzetti et al. 2007). This achieves early patient discharge with economic bene˜ts for the hospital. Our tertiary referral center receives a large number of patient referrals with complex intraabdominal disease and sepsis secondary to colorectal pathology or previous colorectal resections. A signi˜cant proportion are malnourished. In nutritionally depleted patients it may be prudent to modify or delay the surgical procedure performed. Parenteral nutrition (PN) may be needed as well. Advances in radiological intervention allow most patients with intraabdominal sepsis to undergo percutaneous drainage, avoiding the surgical stress of a further laparotomy until one is con˜dent that their nutritional status is optimized (Brolin et al. 1984). Thus a signi˜cant percentage of patients referred to our institute for colorectal intervention will require a period of nutritional support prior to surgery, which may then have to be continued in the postoperative period until intestinal function returns. In obese patients we may modify the proposed colorectal treatment due to the anatomical problems associated with increased body mass index (BMI).
