{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:26:18Z","timestamp":1788863178054,"version":"build-2803163510"},"reference-count":0,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,4,19]],"date-time":"2014-04-19T00:00:00Z","timestamp":1397865600000},"content-version":"vor","delay-in-days":4887,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2000,12,1]],"date-time":"2000-12-01T00:00:00Z","timestamp":975628800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2000,12,1]],"date-time":"2000-12-01T00:00:00Z","timestamp":975628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2000,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Enteral nutrition (EN) and total parenteral nutrition (TPN) may provide life\u2010sustaining therapy for surgical patients. The duration of nutritional therapy (enteral or parenteral) implies distinct access routes. We review the main aspects related to access routes for nutrient delivery. The enteral route, whenever feasible, is preferred. For EN lasting less than 6 weeks, nasoenteric tubes are the route of choice. Conversely, enterostomy tubes should be used for longer\u2010term enteral feeding and can be placed surgically or with fluoroscopic and endoscopic assistance. The first choice for patients who will not be submitted to laparotomy is percutaneous endoscopic gastrostomy. Postpyloric access, although not consensual, must be considered when there is a high risk of aspiration. For intravenous delivery of nutrients lasting less than 10\u00a0days, the peripheral route can be used. However, because of frequent infusion phlebitis, its role is still in discussion. Central venous catheters (CVCs) for TPN delivery may be (1) nonimplantable, percutaneous, nontunneled\u2014used for a few days to 3 to 4 weeks; (2) partially implantable, percutaneous, tunneled\u2014used for longer periods and permanent access; or (3) totally implantable subcutaneous ports\u2014also used for long\u2010term or permanent access. The subclavian vein is usually the insertion site of choice for central venous catheters. Implantable ports are associated with lower rates of septic complications than percutaneous CVCs. The catheter with the least number of necessary lumens should be applied. Central venous nutrient delivery can also be accomplished through peripherally inserted central catheters, which avoid insertion\u2010related risks.<\/jats:p>","DOI":"10.1007\/s002680010264","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T05:57:49Z","timestamp":1030255069000},"page":"1468-1476","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Access Routes for Nutritional Therapy"],"prefix":"10.1002","volume":"24","author":[{"given":"Dan L.","family":"Waitzberg","sequence":"first","affiliation":[{"name":"Department of Gastroenterology University of Sao Paulo Medical School R. Maestro Cardim 1175, 01323\u2010001 S\u00e3o Paulo\u2010SP Brazil<!--<country1>BRAZIL<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caio","family":"Plopper","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Sao Paulo Medical School R. Maestro Cardim 1175, 01323\u2010001 S\u00e3o Paulo\u2010SP Brazil<!--<country1>BRAZIL<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo M.","family":"Terra","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Sao Paulo Medical School R. Maestro Cardim 1175, 01323\u2010001 S\u00e3o Paulo\u2010SP Brazil<!--<country1>BRAZIL<\/country1>-->"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,19]]},"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s002680010264.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s002680010264\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s002680010264","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s002680010264.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T19:32:45Z","timestamp":1705001565000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s002680010264"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,12]]},"references-count":0,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2000,12]]}},"alternative-id":["10.1007\/s002680010264"],"URL":"https:\/\/doi.org\/10.1007\/s002680010264","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,12]]},"assertion":[{"value":"19 April 2014","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}