title: COST-EFFECTIVENESS OF PERIOPERATIVE IMMUNONUTRITION IN GASTROINTESTINAL ONCOLOGIC SURGERY: A SYSTEMATIC REVIEW.
abstract: Costs, length of hospital staying and morbidity are frequently and significantly increased as a result of infections and other complications following surgical procedure for gastrointestinal tract cancer. Recently, improving host defence mechanisms have become a target of interest. Immunonutrition aims at improving immunity, most likely providing key nutrients to maintain T-lymphocyte and other host defence.
  
  
  
  To evaluate the immunonutrition in cancer patients who are operated by digestive diseases and assess the cost-effectiveness of this supplementation.
  
  
  
  This study consisted of a systematic review of the literature based on reference analyses retrieved from current databases such as PubMed, Lilacs and SciELO. The search strategy was defined by terms related to immunonutrition [immunonutrition, arginine, omega-3 and nucleotides] in combination with [costs, cost-effective and cost-effectiveness] as well as [gastrointestinal cancer surgery, oesophageal, gastric or pancreatic surgery] in English, Portuguese or Spanish language. For cost analyses, currencies used in the manuscripts were all converted to American dollars (US$) in order to uniform and facilitate comparison. Six prospective randomized studies were included in this review.
  
  
  
  The cost-effectiveness was positive in most of studies, demonstrating that this diet can significantly reduce hospital costs in the North hemisphere. However, similar studies needed to be carried to determine such results among us.
authors.affiliation: Multidisciplinary Integrated Health in Critical Adult Residency Program.
authors.forename: Audrey Machado Dos
authors.initials: AM
authors.lastname: Reis
authors.affiliation: Southern Surgical Oncology Research Group and Post-Graduate Program of Surgery, Faculty of Medicine, Rio Grande do Sul Federal University and Department of Surgery, Hospital de Clínicas de Porto Alegre University Attached Hospital, Porto alegre, RS, Brazil.
authors.forename: Geórgia Brum
authors.initials: GB
authors.lastname: Kabke
authors.affiliation: Southern Surgical Oncology Research Group and Post-Graduate Program of Surgery, Faculty of Medicine, Rio Grande do Sul Federal University and Department of Surgery, Hospital de Clínicas de Porto Alegre University Attached Hospital, Porto alegre, RS, Brazil.
authors.forename: Ana Valéria Gonçalves
authors.initials: AV
authors.lastname: Fruchtenicht
authors.affiliation: Southern Surgical Oncology Research Group and Post-Graduate Program of Surgery, Faculty of Medicine, Rio Grande do Sul Federal University and Department of Surgery, Hospital de Clínicas de Porto Alegre University Attached Hospital, Porto alegre, RS, Brazil.
authors.forename: Taiane Dias
authors.initials: TD
authors.lastname: Barreiro
authors.affiliation: Southern Surgical Oncology Research Group and Post-Graduate Program of Surgery, Faculty of Medicine, Rio Grande do Sul Federal University and Department of Surgery, Hospital de Clínicas de Porto Alegre University Attached Hospital, Porto alegre, RS, Brazil.
authors.forename: Luis Fernando
authors.initials: LF
authors.lastname: Moreira
mesh_terms: D003362:Cost-Benefit Analysis; D004032:Diet / Q000191:economics*; D013505:Digestive System Surgical Procedures; D005770:Gastrointestinal Neoplasms / Q000191:economics* / Q000601:surgery*; D006801:Humans; D007167:Immunotherapy / Q000191:economics*; D019990:Perioperative Care / Q000191:economics* / Q000379:methods*