Immunonutrition and upper gastrointestinal surgery: what really matters.
Patients with upper gastrointestinal cancer or other surgical diseases are at high risk for both mechanical and infectious complications. The disease process itself places these patients at increased risk for malnutrition, with subsequent postoperative complications. Because these surgeries are semielective, a period of time is available to optimize the patient's condition. There are several trials that suggest preoperative immunonutrition supplementation improves outcomes and is cost-effective by reducing complications. However, the most important choice a patient or clinician can make may well be by whom and where the surgery is performed.
Sax
Harry C
HC
Department of Surgery, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906, USA. hsax@lifespan.org
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004032:Diet / Q000145:classification*; D004750:Enteral Nutrition; D016629:Esophagectomy / Q000009:adverse effects; D005743:Gastrectomy / Q000009:adverse effects; D005770:Gastrointestinal Neoplasms / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D006761:Hospitals / Q000592:standards; D006801:Humans; D044342:Malnutrition / Q000209:etiology / Q000517:prevention & control; D009752:Nutritional Status; D019990:Perioperative Care / Q000592:standards; D011183:Postoperative Complications / Q000517:prevention & control; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic