• Soo Young Lee, Jaram Lee, Hyeong-Min Park, Chang Hyun Kim, and Hyeong Rok Kim.
• Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, South Korea.
• Ann. Surg. 2023 Mar 1; 277 (3): 381386381-386.

ObjectiveThis study aimed to assess the impact of preoperative immunonutrition on the outcomes of colon cancer surgery.BackgroundAlthough current guidelines recommend that immunonutrition should be prescribed for malnourished patients before major gastrointestinal surgery, the benefit of preoperative immunonutrition remains debatable.MethodsBetween April 2019 and October 2020, 176 patients with primary colon cancer were enrolled and randomly assigned (1:1) to receive preoperative immunonutrition plus a normal diet (n = 88) or a normal diet alone (n = 88). Patients in the immunonutrition group received oral nutritional supplementation (400 mL/d) with arginine and ω-3 fatty acids for 7 days before elective surgery. The primary endpoint was the rate of infectious complications, and the secondary endpoints were the postoperative complication rate, change in body weight, and length of hospital stay.ResultsThe rates of infectious (17.7% vs 15.9%, P = 0.751) and total (31.6% vs 29.3%, P = 0.743) complications were not different between the two groups. Old age was the only significant predictive factor for the occurrence of infectious complications (odds ratio = 2.990, 95% confidence interval 1.179-7.586, P = 0.021). The length of hospital stay (7.6 ± 2.5 vs 7.4 ± 2.3 days, P = 0.635) and overall change in body weight ( P = 0.379) were similar between the two groups. However, only the immunonutrition group showed weight recovery after discharge (+0.4 ± 2.1 vs -0.7 ± 2.3 kg, P = 0.002).ConclusionsPreoperative immunonutrition was not associated with infectious complications in patients undergoing colon cancer surgery. Routine administration of immunonutrition before colon cancer surgery cannot be justified.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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