Ann Clin Nutr Metab.  2023 Aug;15(2):46-50. 10.15747/ACNM.2023.15.2.46.

Role of preoperative immunonutrition in patients with colorectal cancer: a narrative review

• Lee SY
• Park Hm
• Kim CH
• Kim HR

• KMID: 2545176
• DOI: http://doi.org/10.15747/ACNM.2023.15.2.46

Abstract

Purpose
Colorectal cancer surgery presents challenges due to surgical stress and immunosuppression, leading to postoperative complications. Nutrition is crucial for colorectal cancer patients who are prone to malnutrition. This study aims to provide a comprehensive review of the role of preoperative immunonutrition in colorectal cancer surgery.
Current concept
Preoperative immunonutrition, consisting of immunonutrients such as arginine, ω-3 fatty acids, and nucleotides, has emerged as a potential strategy to enhance surgical outcomes by modulating immune responses and reducing complications. Current guidelines recommend preoperative oral nutritional supplements for major abdominal surgery and immunonutrition for nutritionally high-risk patients. Meta-analysis have demonstrated significant decreases in infectious complications and hospital stay durations with preoperative immunonutrition. However, limitations such as publication bias and heterogeneity in the previous studies should be considered. Further research should focus on the optimal timing, duration, and amount of immunonutrition; the patient populations that would benefit most; and the integration of immunonutrition into enhanced recovery after surgery protocols.
Conclusion
While preoperative immunonutrition shows promise, additional research is crucial to refine protocols and establish optimal clinical practice utilization.

Keyword

Immunonutrition diet; Colorectal neoplasms; General surgery; Postoperative complications