Manajemen Nutrisi Pada Diet Pasca Bedah Lambung Untuk Mendukung Pemulihan Pasien : Studi Literatur

Abstract

Latar Belakang : 

Pasien pasca bedah lambung, seperti gastrektomi, menghadapi risiko malnutrisi yang signifikan akibat perubahan anatomi dan fisiologis pada sistem pencernaan. Penurunan kapasitas lambun, gangguan motilitas usus, dan perubahan hormonal berdampak pada asupan makanan, yang pada akhirnya dapat memperlambat penyembuhan luka, meningkatkan komplikasi pasca bedah, dan memperpanjang masa rawat inap.

Tujuan :

Kajian literatur ini bertujuan untuk mensintesis bukti-bukti ilmiah terkini mengenai strategi manajemen nutrisi pada pasien pasca bedah lambung, dengan fokus pada waktu pemberian, rute, dan komposisi diet. Secara khusus, tinjauan ini menganalisis efektifitas pemberian nutrisi oral atau enteral dini serta peran suplemen nutrisi dalam mendukung pemulihan klinis dan fungsional pasien.

Metode : 

Studi ini merupakan literature review naratif yang menganalisis 15 artikel penelitian, terdiri dari uji klinis acak (RCT), studi kohort, systematic review, dan pedoman klinis yang diterbitkan antara tahun 2020 hingga 2025. Pencarian literatur dilakukan pada database elektrolit seperti PubMed, ScienceDirect, SpringerLink, MDPI, serta jurnal nasional terakreditasi. Analisis data dilakukan secara deskriptif naratif dengan mengekstraksi temuan terkait waktu pemberian nutrisi, rute pemberian, komposisi diet, dan hasil klinis.

Hasil : 

Pemberian nutrisi oral atau enteral dini (<24 jam) setelah operasi aman dan efektif mempercepat pemulihan fungsi gastrointestinal, menurunkan komplikasi, serta memperpendek lama rawat inap. Suplementasi oral nutrirional supplements (ONS) terbukti mempertahankan status gizi dan massa otot tanpa lemak.

Kesimpulan : 

Implementasi prinsip nutrisi dini sesuai pedoman ESPEN dan ERAS, yang mencakup pemberian makan segera, diet progresif, serta suplementasi yang adekuat, merupakan landasan manajemen nutrisi yang efektif pasca bedah lambung. Pendekatan multidisiplin yang melibatkan dokter, nutrisionis, dan perawat, serta pemantauan jangka panjang untuk defisiensi mikronutrien, sangat penting untuk mengoptimalkan hasil klinis dan kualitas hidup pasien gastrektomi di Indonesia.

Background:

Patients undergoing gastric surgery, such as gastrectomy, face a significant risk of malnutrition due to anatomical and physiological changes in the digestive system. Reduced gastric capacity, impaired intestinal motility, and hormonal alterations may affect food intake, ultimately delaying wound healing, increasing postoperative complications, and prolonging the length of hospital stay.

Objective:

This literature review aimed to synthesize current scientific evidence regarding nutritional management strategies in patients following gastric surgery, with a focus on the timing, route, and composition of nutritional support. Specifically, this review analyzed the effectiveness of early oral or enteral nutrition and the role of nutritional supplementation in supporting patients' clinical and functional recovery.

Methods:

This study was a narrative literature review analyzing 15 research articles, including randomized controlled trials (RCTs), cohort studies, systematic reviews, and clinical guidelines published between 2020 and 2025. The literature search was conducted using electronic databases, including PubMed, ScienceDirect, SpringerLink, MDPI, as well as accredited national journals. Data were analyzed using a descriptive narrative approach by extracting findings related to the timing of nutritional administration, routes of delivery, dietary composition, and clinical outcomes.

Results:

Early oral or enteral nutrition administered within 24 hours after surgery was found to be safe and effective in accelerating the recovery of gastrointestinal function, reducing postoperative complications, and shortening the length of hospital stay. Supplementation with oral nutritional supplements (ONS) was also shown to help maintain nutritional status and preserve lean body mass.

Conclusion:

The implementation of early nutrition principles in accordance with ESPEN and ERAS guidelines, including early feeding, progressive dietary advancement, and adequate nutritional supplementation, provides an effective foundation for nutritional management following gastric surgery. A multidisciplinary approach involving physicians, nutritionists, and nurses, along with long-term monitoring for micronutrient deficiencies, is essential to optimize clinical outcomes and improve the quality of life of gastrectomy patients in Indonesia.