Malnourishment of surgical patients has long been recognized as contributing to postoperative morbidity and mortality.1,2 Early protocols calling for lengthy perioperative patient fasting have been replaced by interventions aimed at diagnosing and addressing each patient’s nutritional and metabolic needs; maintaining fluid and electrolyte balance, energy, and protein stores; and preserving muscle strength and gut microbiome by restoring oral feeding as soon as possible postoperatively.3 Interventions to achieve this physiologic balance have been the subject of considerable research, yet neither comprehensive preoperative programs4 nor early postoperative oral feeding5 have been reported to result in consistently improved clinical outcomes following abdominal surgery. This installment of Evidence Corner explores 2 systematic reviews, one of which presents clinical outcomes of early resumption of enteral food intake within 24 hours after gastrointestinal (GI) surgery,6 and the other presents clinical outcomes of perioperatively enhanced nutrition for those undergoing radical cystectomy (RC) for bladder cancer.7
THE CONTROL OF WATER AND ELECTROLYTE BALANCE IN SURGICAL PATIENTS