Preoperative Immunonutrition in Gastrointestinal Cancer Patients

Surgical procedures due to gastrointestinal tumors are associated with increased risk of postoperative complications and mortality. This is a result of malnutrition and impairment of the immune system. Using nutritional treatment containing immunomodulatory components before surgery may improve the nutritional status of patients and also the immune system by stimulating the host`s immune response, improving the nitrogen balance and controlling the inflammatory response. The nutrients with immunomodulatory effect include: arginine, glutamine, -3 fatty acids, and nucleotides. Despite many clinical research the role of preoperative immunonutrition remains unambiguous. The optimal dose of using it is also unknown. The aim of this study was analysis of the impact of preoperative immunonutrition on postoperative complications in patients with gastrointestinal cancer treated surgically. The authors reviewed the literature of effect of preoperative immunonutrition on postoperative complications, mortality, and length of stay in hospital in gastrointestinal cancer patients. The studies including immunonutrients such as arginine, glutamine, -3 fatty acids and RNA (ribonucleic acid) were reviewed. Preoperative immunonutrition seems to be effective in the prevention of postoperative complications, both infectious and noninfectious, as well reduction of mortality and shorter length of stay in hospital. Patients with malnutrition are definitely benefit of this kind of support. Further studies are needed to assess the effect of preoperative immunonutrition in patients treated surgically due to gastrointestinal cancer.

Anna Sacharczuk, Zbigniew Kamocki

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