(Par-)Enterale Ernährungstherapie beim Tumorpatienten – neue Konzepte und aktuelle Leitlinienempfehlungen

Einleitung

Viele chirurgische Tumorpatienten wirken auch bei multimodaler Therapie überernährt oder sogar adipös und nicht mangelernährt. Dies suggeriert auch für den Fall eines komplizierten Verlaufs bestehende Reserven. So ist eine auf den ersten klinischen Blick offensichtliche Mangelernährung eher selten. Deswegen gilt die perioperative Ernährung als „traditionell“ und überholt und wird bei konsequentem Einsatz eines ERAS-Fast-Track-Programms (ERAS: Enhanced Recovery after Surgery) als überflüssig erachtet. Selbst bei Übergewicht und Adipositas können jedoch Defizite in der Körperzusammensetzung vorliegen. Die Verminderung der Muskelmasse – Sarkopenie – hat erhebliche Auswirkungen auf die postoperative Funktionalität mit Mobilisation und Atemfunktion. Die prognostische Bedeutung ist signifikant und aktuell für Patienten mit Magen- und Ösophaguskarzinom gezeigt worden [1].

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