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<p>Patients undergoing oncological treatment are frequently affected by disease-related malnutrition. In combination with surgery-induced metabolic stress, the risk of postoperative complications is significantly increased. The prevalence of malnutrition ranges from 20% to 70%, with particularly high rates in patients with gastrointestinal tumors. Malnutrition is linked to numerous adverse outcomes, including increased morbidity and mortality, reduced quality of life, impaired response to therapy, prolonged hospital stays, and increased healthcare costs. Its causes are multifactorial and include both reduced nutritional intake and tumor-associated metabolic alterations leading to systemic inflammation. The Enhanced Recovery After Surgery (ERAS) concept represents a&#xa0;multimodal perioperative care concept in which prehabilitation plays a&#xa0;central role prior to surgery. In addition to physiotherapeutic and psychological interventions, it particularly emphasizes personalized nutritional therapy aimed to optimize preoperative nutritional status. This strategy is based on early malnutrition screening, nutritional assessment, and individualized nutritional support. The process of nutritional therapy is conducted in a&#xa0;stepwise approach, with the primary aim to achieve sufficient oral intake, supplemented, when necessary, by oral nutritional supplements, enteral or parenteral nutrition. In the preoperative phase, individualized nutritional therapy is recommended for 7–14&#xa0;days, particularly for malnourished patients, even if the surgery must be postponed. Preoperative carbohydrate loading represents another core component of the ERAS protocol and serves to attenuate perioperative catabolism. Adherence to guidelines in the preoperative phase can substantially reduce postoperative complications.</p>

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Ernährung in der Prähabilitation

  • 期刊论文

  • 发表日期：

    2026年1月14日

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  • Nicole Witt,
  • Viktoria Mathies

摘要

Patients undergoing oncological treatment are frequently affected by disease-related malnutrition. In combination with surgery-induced metabolic stress, the risk of postoperative complications is significantly increased. The prevalence of malnutrition ranges from 20% to 70%, with particularly high rates in patients with gastrointestinal tumors. Malnutrition is linked to numerous adverse outcomes, including increased morbidity and mortality, reduced quality of life, impaired response to therapy, prolonged hospital stays, and increased healthcare costs. Its causes are multifactorial and include both reduced nutritional intake and tumor-associated metabolic alterations leading to systemic inflammation. The Enhanced Recovery After Surgery (ERAS) concept represents a multimodal perioperative care concept in which prehabilitation plays a central role prior to surgery. In addition to physiotherapeutic and psychological interventions, it particularly emphasizes personalized nutritional therapy aimed to optimize preoperative nutritional status. This strategy is based on early malnutrition screening, nutritional assessment, and individualized nutritional support. The process of nutritional therapy is conducted in a stepwise approach, with the primary aim to achieve sufficient oral intake, supplemented, when necessary, by oral nutritional supplements, enteral or parenteral nutrition. In the preoperative phase, individualized nutritional therapy is recommended for 7–14 days, particularly for malnourished patients, even if the surgery must be postponed. Preoperative carbohydrate loading represents another core component of the ERAS protocol and serves to attenuate perioperative catabolism. Adherence to guidelines in the preoperative phase can substantially reduce postoperative complications.