Effect of timing of pharmaconutrition (immunonutrition) administration on outcomes of elective surgery for gastrointestinal malignancies: a systematic review and meta-analysis.

  title={Effect of timing of pharmaconutrition (immunonutrition) administration on outcomes of elective surgery for gastrointestinal malignancies: a systematic review and meta-analysis.},
  author={Emma J Osland and Md. Belal Hossain and Shahjahan Khan and Muhammed Ashraf Memon},
  journal={JPEN. Journal of parenteral and enteral nutrition},
  volume={38 1},
BACKGROUND Pharmaconutrition has previously been reported in elective surgery to reduce postoperative infective complications and duration of hospital length of stay. OBJECTIVE To update previously published meta-analyses and elucidate potential benefits of providing arginine-dominant pharmaconutrition in surgical patients specifically with regard to the timing of administration of pharmaconutrition. DESIGN Randomized controlled trials comparing the use of pharmaconutrition with standard… 

Pharmaconutrition administration on outcomes of elective oncological surgery for gastrointestinal malignancies: is timing everything?-a review of published meta-analyses until the end of 2016.

A critical re-appraisal of the use and recommendations of pharmaconutrition in this group of patients is urgently warranted to resolve some of the above mentioned issues.

Clinical Efficacy of Perioperative Immunonutrition Containing Omega-3-Fatty Acids in Patients Undergoing Hepatectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Given its positive impact on postoperative complications and the tendency to shorten the length of hospital stay, perioperative immunonutrition should be encouraged in patients undergoing hepatectomy.

The Effect of Preoperative Oral Immunonutrition on Complications and Length of Hospital Stay After Elective Surgery for Pancreatic Cancer–A Randomized Controlled Trial

It is concluded that the lack of effect of supplementary per oral immunonutrition seven days before surgery for pancreatic cancer could be due to the limited dosage of IN, and/or because only 40% of the patients were at nutritional risk.

Preoperative standard oral nutrition supplements vs immunonutrition: results of a systematic review and meta-analysis.

Impact of Oral Immunonutrition on Postoperative Morbidity in Digestive Oncologic Surgery: A Nation-Wide Cohort Study.

The preoperative use of immunonutrition before major oncologic digestive surgery was not associated with any significant difference in morbidity or mortality, however, the LOS was significantly shorter in the IN-group.

Immunonutrition Support for Patients Undergoing Surgery for Gastrointestinal Malignancy: Preoperative, Postoperative, or Perioperative? A Bayesian Network Meta-Analysis of Randomized Controlled Trials

EIN support is promising alternative for operation management in comparison with standard EN, and perioperative EIN regime is the optimum option for managing clinical status of patients who underwent selective surgery for GI cancer.

The Impact of Preoperative Immunonutrition and Standard Polymeric Supplements on Patient Outcomes After Pelvic Exenteration Surgery, Taking Compliance Into Consideration: A Randomized Controlled Trial.

Preoperative immunonutrition did not significantly impact length of stay or postoperative complications compared with standard polymeric supplements after pelvic exenteration surgery, despite controlling for protein, energy, and volume.

Meta-analyses Optimal postoperative nutrition support for patients with gastrointestinal malignancy : A systematic review and meta-analysis

Early use of Enteral nutrition in digestive tumor patients after surgery could significantly reduce the postoperative complications and shorten the length of hospital stay, IEN should be the optimal management, while the use of parenteral nutrition should be restrict to few patients with severe intolerance to enteral nutrition.



Application of perioperative immunonutrition for gastrointestinal surgery: a meta-analysis of randomized controlled trials.

Perioperative diet adding immunonutrition is effective and safe to decrease postoperative infection and reduce length of hospital stay through improving immunity of postoperative patients as compared with the control group.

Immunonutrition in high-risk surgical patients: a systematic review and analysis of the literature.

An immunomodulating enteral diet containing increased amounts of both arginine and fish oil should be considered in all high-risk patients undergoing major surgery, and it is suggested that immunonutrition be initiated preoperatively when feasible.

Outcome and cost-effectiveness of perioperative enteral immunonutrition in patients undergoing elective upper gastrointestinal tract surgery: a prospective randomized study.

The perioperative administration of an enteral immunonutrition decreased the early occurrence of postoperative infections and reduced substantially the treatment costs of the complications after major upper gastrointestinal tract surgery.

Perioperative immunonutrition in patients undergoing cancer surgery: results of a randomized double-blind phase 3 trial.

Perioperative administration of a supplemented enteral formula significantly reduced postoperative infections and length of stay in patients undergoing surgery for cancer.

Immunonutrition in Patients Undergoing Major Upper Gastrointestinal Surgery: A Prospective Double-Blind Randomised Controlled Study

This study has not shown a benefit of immunonutrition through changes in inflammatory or nutritional markers, a decrease in length of hospital stay, or other morbidity.

Nutritional approach in malnourished surgical patients: a prospective randomized study.

Perioperative immunonutrition seems to be the best approach to support malnourished patients with cancer.

The Impact of Immunostimulating Nutrition on Infectious Complications After Upper Gastrointestinal Surgery: A Prospective, Randomized, Clinical Trial

This study failed to demonstrate any clear advantage of routine postoperative immunonutrition in patients undergoing elective upper gastrointestinal surgery, and both enteral and parenteral treatment options showed similar efficacy, tolerance, and effects on protein synthesis.

Preoperative Enteral Immunonutrition Improves Postoperative Outcome in Patients with Gastrointestinal Cancer

Preoperative enteral IM in patients with GI cancer improves nutritional status and immunity and decreases the incidence of postoperative complications and infections.