ROLE DE LA PRISE EN CHARGE NURITIONNELLE PERI OPERATOIRE SUR LA REHABILITATION POSTOPERATOIRE EN CHIRURGIE DIGESTIVE A SOISSONS - FRANCE

Perioperative nutritional management plays an essential role in postoperative rehabilitation: postoperative complications increase when perioperative malnutrition is present. Thesecomplications associatedto undernutrition can range from a simple hydro-electrolyte disorders prolonging the duration of hospitalization until death (29% versus 4% in normal subjects). Objective: To assessthe role of perioperative nutritional support on postoperative rehabilitation in digestive surgery. Type of study: Observational, analytical, prospective, monocentric study. Patients and methods: All patients hospitalized from May 2018 to April 2019 (12 months) who underwent digestive surgery by midline laparotomy were included. The Chi² test was used for correlation analysis between perioperative nutrition and postoperative rehabilitation. A p-value of less than 0.05 was considered significant. Results: Forty-seven patients were selected, aged 63 [32-100] years, sex ratio 1.47. Eighteen patients received preoperative nutritional support and 44 received postoperative nutrition. Pre- and postoperative protein intakes was correlated with first rising (p = 0,036 X² = 8,516) and complete ambulation (p <0,001 X² = 26,605), respectively. Postoperativemobilizationwasearlier in patients who beneficiated fromearlyresumption of postoperativeenteral nutrition (p <0,001 X² = 51,547). Perioperative nutrition (especially aminoacids intake) reduced the occurrence of postoperative complications and the duration of hospitalizationand improved survival at D30 (p = 0,002 X² = 14,586 for preoperative amino acids, p = 0,008, X² = 17,283 for postoperative amino acids). Conclusion:Digestive surgery being at risk of high morbidity and mortality, caloric and protein intake must be adequate in the perioperative period. Optimal adequate perioperative nutritional support will thus improve postoperative rehabilitation.