[Nutritional therapy in surgical patients: an update]

Area of Science:

• Surgical Nutrition
• Immunonutrition
• Gastrointestinal Surgery

Context:

• Major gastrointestinal surgery necessitates artificial nutritional (AN) support for malnutrition or to manage postoperative metabolic changes.
• Enteral feeding is preferred over parenteral nutrition due to its physiological benefits, lower cost, and improved patient outcomes, including reduced morbidity and hospital stays.
• Surgery-induced immunosuppression and hyperinflammation are significant concerns in postoperative recovery.

Purpose:

• To evaluate the role of artificial nutritional support in major gastrointestinal surgery.
• To highlight the advantages of enteral feeding over parenteral nutrition.
• To assess the impact of pharmaconutrient supplementation on surgical outcomes.

Summary:

• Artificial nutritional support is vital for patients undergoing major gastrointestinal surgery.
• Enteral feeding is recommended over parenteral nutrition for better outcomes and cost-effectiveness.
• Supplementing enteral feeds with pharmaconutrients (arginine, omega-3 fatty acids, glutamine) effectively modulates the immune response and inflammation.
• Evidence-based medicine supports the pre-perioperative use of pharmaconutrient-enriched formulas to decrease infectious complications.

Impact:

• Pharmaconutrient-enriched enteral formulas can significantly reduce infectious complications in surgical patients.
• This approach offers a potential to decrease healthcare resource utilization.
• Optimizing nutritional strategies can lead to better patient recovery and reduced hospital stays.