[In which patients has the efficacy of preoperative artificial nutrition be proved?]

Today a consensus on the value of peroperative nutritional support is not existing, despite a recognized correlation between the stage of denutrition and the postoperative mortality and morbidity rates. This review of 11 prospective randomized studies, comparing undernourished patients with a major malignant or non-malignant surgical illness, according to the use or not of preoperative nutritional support, showed a wide discrepancy between the techniques of denutrition assessment, the underlying surgical disease, the tumor extension, the extend of surgery, the level and duration of nutritional support between the studies. However, among them, those without major bias show that a preoperative nutritional support of at least seven days, decreases significantly the rate of postoperative complications, especially the infection, in the most undernourished patients.