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Maryam Hidayat
Zara Sagheer
Soban Abu Khifs
Eiman khalifa Idris Habani
Yesha Vaghasia
Fatima Ejaz
Abdullah Ahmed Almesri


Dietary supplements, General surgery, Micronutrients, Nutritional intervention, Wound healing.


Background: The efficacy of peri-operative nutritional interventions in enhancing surgical recovery is a subject of considerable medical interest and significance.

Objectives: This prospective, randomized, controlled trial examined the influence of an enhanced recovery after surgery (ERAS) nutritional support regimen on perioperative nutritional status and patient outcomes in a tertiary hospital in KPK.

Methods: 246 participants were designated randomly to either the intervention group or control. The intervention group was given perioperatively-tailored nutritional interventions, and the group serving as control received standard perioperative care and their comparative clinical outcomes were studied.

Results: Intervention group experienced significant reduction in post-operative complications (18.7% vs. 39.8%, p=0.0101) and a shorter average length of hospitalization (3.11+1.24 days vs. 5.52+2.40 days, p=0.0411). Postoperatively, the intervention group had substantially higher levels of major clinical and biochemical parameters than the control group.

Practical implications: The study highlighted implementing the ERAS nutritional support regimen, can result in fewer post-operative complications, shortened hospital stays, increased patient satisfaction, and the need for comprehensive nutritional assessments to ensure optimal perioperative care.

Conclusion: Enhanced recovery after surgery protocol demonstrated significant improvements in the postoperative clinical and biochemical parameters of patients, as well as reduction in hospital duration of stay and increase in patient satisfaction upon discharge.

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1. Fukatsu K. Role of nutrition in gastroenterological surgery. Ann Gastroenterol Surg. 2019 Feb 25;3(2):160-168.
2. Hirsch KR, Wolfe RR, Ferrando AA. Pre- and Post-Surgical Nutrition for Preservation of Muscle Mass, Strength, and Functionality Following Orthopedic Surgery. Nutrients. 2021 May 15;13(5):1675.
3. Breuing J, Könsgen N, Doni K, et al. Information needs of patients undergoing bariatric surgery in Germany: a qualitative study. BMC Health Serv Res. 2022;22:515.
4. Lakananurak N, Gramlich L. The Role of Preoperative Parenteral Nutrition. Nutrients. 2020 May 6;12(5):1320.
5. Venianaki M, Andreou A, Nikolouzakis TK, Chrysos E, Chalkiadakis G, Lasithiotakis K. Factors Associated with Malnutrition and Its Impact on Postoperative Outcomes in Older Patients. J Clin Med. 2021 Jun 9;10(12):2550.
6. Evans DC, Martindale RG, Kiraly LN, Jones CM. Nutrition optimization prior to surgery. Nutr Clin Pract. 2014 Feb;29(1):10-21.
7. Tappenden KA, Quatrara B, Parkhurst ML, Malone AM, Fanjiang G, ZieglerTR. Critical Role of Nutrition in Improving Quality of Care: An Interdisciplinary Call to Action to Address Adult Hospital Malnutrition. J Academy Nutr Dietetics. 2013;113(9):1219-1237.
8. Tourkochristou E, Triantos C, Mouzaki A. The Influence of Nutritional Factors on Immunological Outcomes. Front Immunol. 2021 May 31;12:665968.
9. Pollock GR, Van Way CW 3rd. Immune-enhancing nutrition in surgical critical care. Mo Med. 2012 Sep-Oct;109(5):388-92.
10. A'zim AZA, Zaid ZA, Yusof BNM, Jabar MF, Shahar ASM. Effectiveness of intensive perioperative nutrition therapy among adults undergoing gastrointestinal and oncological surgery in a public hospital: study protocol for a pragmatic randomized control trial. Trials. 2022 Nov 26;23(1):961.
11. Ford KL, Prado CM, Weimann A, Schuetz P, Lobo DN. Unresolved issues in perioperative nutrition: A narrative review. Clin Nutr. 2022 Jul;41(7):1578-1590.
12. Katundu KG, Mutafya TW, Lozani NC, Nyirongo PM, Uebele ME. An observational study of perioperative nutrition and postoperative outcomes in patients undergoing laparotomy at Queen Elizabeth Central Hospital in Blantyre, Malawi. Malawi Med J. 2018 Jun;30(2):79-85.
13. Chen Y, Michalak M, Agellon LB. Importance of Nutrients and Nutrient Metabolism on Human Health. Yale J Biol Med. 2018 Jun 28;91(2):95-103.
14. Raiten DJ, Ashour FAS, Ross AC, Meydani SN, Dawson HD, Stephensen CB, Brabin BJ, Suchdev PS, van Ommen B. Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE)1, 2, 2, 3, 4, 5. J Nutr. 2015;145(5):1039S-1108S.
15. Li YQ, Qu XP, Peng LW, An JY, Liu XW, Zhang Y, Wang C, Jiang X, Gao L, Li G, Wang DL, Zhao DC, Qu Y, Liu B.Targeted nutritional intervention with enhanced recovery after surgery for carotid endarterectomy: A prospective clinical trial. Front Nutr. 2023;10:951174.
16. Hotchkiss RS, Moldawer LL, Opal SM, Reinhart K, Turnbull IR, Vincent JL. Sepsis and septic shock. Nat Rev Dis Primers. 2016 Jun 30;2:16045.
17. Ma X, Xu Y, Qian J, Dai B. Analysis of influencing factors of community-acquired pneumonia with deep venous thrombosis in elderly communities. Ann Palliat Med. 2022 Jun;11(6):1997-2006.
18. Nunns M, John JB, McGrath JS, Shaw L, Briscoe S, Thompson Coon J, Hemsley A, Lovegrove CJ, Thomas D, Mythen MG, Anderson R. Evaluating enhanced recovery after surgery: time to cover new ground and discover the missing patient voice. Perioper Med (Lond). 2020 Sep 14;9:27.
19. Saunders J, Smith T. Malnutrition: causes and consequences. Clin Med (Lond). 2010 Dec;10(6):624-7.
20. Klek S, Sierzega M, Szybinski P, Szczepanek K, Scislo L, Walewska E, Kulig J. The Immunomodulating Enteral Nutrition in Malnourished Surgical Patients—A Prospective, Randomized, Double-Blind Clinical Trial. Clin Nutr. 2011;30:282–288.