Preoperative nutrition in colorectal cancer surgery: mini review

In colorectal cancer patients, malnutrition, sarcopenia, and even cachexia are highly prevalent (24-65%); those patients who undergo surgery with a compromised nutritional status tend to have more complications (OR: 1.84; 1.35-2.48). Therefore, proper nutritional management before surgery is essential. The principal therapeutic option for patients with colorectal cancer is surgery; in this way, these patients are vulnerable to a worse prognosis if a preoperative nutritional intervention is not considered. An individualized, well-designed nutrition care plan, as part of a multimodal therapeutic approach, that promotes adequate energy and protein intake to counteract catabolism and preserve muscle mass can help improve postoperative outcomes. Other strategies that may be useful for patients undergoing colorectal cancer surgery are immunonutrition and micronutrient supplementation. The combined use of certain immunonutrients, such as polyunsaturated fatty acids, branched-chain amino acids, arginine, glutamine, and nucleotides, has been suggested in some studies to help reduce surgery-related complications and infections, promote better wound healing, and shorten hospital stay after colorectal surgery. Certain micronutrients, such as vitamin C and zinc, can enhance the clinical effects of prior nutritional interventions and promote postoperative recovery. Nevertheless, limitations and mixed results in the current evidence preclude recommending these strategies in routine clinical practice. An individualized approach for each patient should be considered to improve surgical outcomes through nutrition.