Annals of Clinical Nutrition and Metabolism

Review

Role of preoperative immunonutrition in patients with colorectal cancer: a narrative review: Soo Young Lee, Hyeung-min Park, Chang Hyun Kim, Hyeong Rok Kim; Ann Clin Nutr Metab 2023;15(2):46-50. Published online August 1, 2023; DOI: https://doi.org/10.15747/ACNM.2023.15.2.46

Abstract PDF: 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.

Review Article

Effect of Probiotics/Synbiotics on Postoperative Outcomes in Patients Undergoing Abdominal Surgery: In Ja Park; Ann Clin Nutr Metab 2022;14(1):10-19. Published online June 1, 2022; DOI: https://doi.org/10.15747/ACNM.2022.14.1.10

Abstract PDF: Environmental factors, drugs, diet, and surgery alter the composition of the gut microbiota leading to the production of different metabolites or toxins that can cause disease or delay postoperative recovery. Surgical damage leads to gut barrier disruption, increased intestinal permeability, gut microbial imbalance, and immunologic compromise of the host with subsequent bacterial translocation from the gastrointestinal tract to systemic circulation. Therefore, perioperative stabilization of the intestinal microbiota is a potential method of reducing postoperative complication rates. Probiotics have been proposed as a viable option for prophylaxis of postoperative infections through increased intestinal motility to prevent bacterial overgrowth, improve gut barrier function, and modulate immune response. This review investigates microbial changes after surgery and the influence of probiotics on postoperative microbial composition. Infectious postoperative complications and immunologic changes related to probiotics/synbiotics were also reviewed in patients who underwent abdominal surgery.

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