[Renutrition and perioperative immunonutritions in programmed adult digestive surgery]

Improving perioperative nutritional management in patients undergoing surgery for severe digestive disease can reduce postoperative morbidity. This nutritional management comprises two facets: the pre- and/or postoperative detection (with the surgeon playing an important role because of the high prevalence of denutrition in digestive oncology) and correction of denutrition; the value of immunonutrition using nutrients that can reduce postoperative morbidity by modulating the immune response in patients with and without a degraded nutritional state. The tools available to the clinician to assess denutrition are detailed and the guidelines established in 2005 by the French Digestive Surgery Society are compared to the recent data from the literature.