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The place of preoperative immunonutrition in the era of fast-track surgery

  • Preliminary Clinical Study
  • Published:
Hellenic Journal of Surgery

Abstract

Background — Aim

Clinical studies over the last ten years have shown that preoperative enteral immunonutrition after major gastrointestinal operations reduces morbidity and improves outcome. Similar results have been reported with the application of Enhanced Recovery After Surgery (ERAS) programmes. The aim of this study was to determine whether the addition of preoperative enteral immunonutrition to an ERAS program further decreases postoperative morbidity and the length of hospital stay in patients undergoing major gastrointestinal surgery.

Patients-Methods

A retrospective study was conducted of 19 patients who, over a six-month period, had undergone a planned elective operation for benign or malignant intra-abdominal illness and were treated according to an ERAS program. Before surgery, 10 patients (group A) received 900 ml/day of an immune-enhancing oral diet for 6 days before surgery, together with normal food, while the remaining 9 patients (group B) just received a normal diet. Statistical analysis was done by the use of Fisher’s exact test and Mann-Whitney test.

Results

All surgical procedures were performed by the same surgical team. The two groups were comparable, in terms of age, gender, ASA grade, nutritional status, type of disease and type of surgery. Complication rates were 20% in group A, and 10% in group B (p=0.5). Furthermore, no significant differences between the two groups were found with regard to mortality and length of hospital stay. However, the comparison of the duration of stay in upper and lower gastrointestinal surgery revealed that patients in Group A who underwent surgery in the lower abdomen had a significantly shorter length of hospital stay compared with their counterparts in Group B (p=0.03).

Conclusion

In patients who undergo major intra-abdominal surgery, treated with an ERAS regimen, the preoperative administration of immune-enhancing diet does not further reduce morbidity and mortality. However, it enables a shorter length of hospital stay, particularly for those undergoing surgery of the lower abdomen.

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Authors and Affiliations

  1. Department of Surgery, “Agios Andreas” General Hospital, Patra, Greece

    V. Alivizatos, V. Gavala, P. Athanasopoulos & N. Apostolopoulos

Authors
  1. V. Alivizatos
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  2. V. Gavala
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  3. P. Athanasopoulos
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  4. N. Apostolopoulos
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Correspondence to V. Alivizatos.

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Alivizatos, V., Gavala, V., Athanasopoulos, P. et al. The place of preoperative immunonutrition in the era of fast-track surgery. Hellenic J Surg 84, 225–229 (2012). https://doi.org/10.1007/s13126-012-0033-x

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  • DOI: https://doi.org/10.1007/s13126-012-0033-x

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