Does perioperative immunonutrition reduce postoperative complications in patients with gastrointestinal cancer undergoing operations?

Abstract

Perioperative immune modulation using specialized enterai diets containing specific immunonutrients may improve postoperative outcomes in critically ill patients compared with standard formulas. A study from Italy involving 305 patents with histologically confirmed cancer of the gastrointestinal tract undergoing major elective surgery and preoperative weight loss <10% demonstrated that a specialized preoperative oral formula enriched with arginine, ω-3 fatty acids, and RNA for 5 days before surgery with no nutritional support postoperatively (preoperative group) was as effective as pre- and postoperative administration of the same enriched formula (perioperative group) in decreasing the incidence of postoperative infections and length of hospital stay. Both pre- and perioperative immunonutritional strategies were superior to the conventional approach (no artificial nutrition perioperatively).