Ann Clin Nutr Metab.  2024 Dec;16(3):134-148. 10.15747/ACNM.2024.16.3.134.

Perioperative nutritional practice of surgeons in Korea: a survey study

• Park JH
• Jung MR
• Kim SH
• Kim H
• Lee G
• Min JS
• Oh HK
• Bae JH
• Chung Y
• Han DS
• Ryu SW
• The External Relation Committee of the Korean Society of Surgical Metabolism and Nutrition

• KMID: 2562431
• DOI: http://doi.org/10.15747/ACNM.2024.16.3.134

Abstract

Purpose
Enhanced recovery after surgery (ERAS) protocols advocate reduced fasting and early nutrition to improve recovery in surgical patients. However, data on ERAS implementation among Korean surgeons performing major abdominal surgeries remain sparse.
Methods
A survey conducted by the External Relation Committee of the Korean Society of Surgical Metabolism and Nutrition assessed perioperative nutritional practices among 389 Korean general surgeons from February to September 2023. The survey covered preoperative fasting, carbohydrate drinks, nasogastric tube use, postoperative dietary progression, parenteral nutrition (PN), and oral supplements, yielding 551 responses stratified by specialty.
Results
More than 80% of respondents practiced “midnight NPO (Nil Per Os)” fasting, often at the anesthesiology department’s request, while 70%–80% reported no use of preoperative carbohydrate drinks. Most surgeons began dietary progression with water on postoperative day one, advancing to a liquid or soft diet by day two. PN was routinely prescribed by 49% of respondents, with a common dosage of 1,000–1,500 kcal/d. Oral supplements were selectively provided, with 21% of surgeons prescribing them universally.
Conclusion
The results reveal significant variability in perioperative nutrition practices across Korean surgical specialties, with many adhering to traditional practices despite ERAS guidelines. These findings highlight a need for standardized guidelines in Korea to optimize perioperative nutritional support and improve patient recovery outcomes following major abdominal surgeries.

Keyword

Enhanced recovery after surgery; Enteral nutrition; General surgery; Parenteral nutrition; Surveys and questionnaires