Perioperative Immunonutrition in Patients Undergoing Cancer Surgery

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Abstract
DESPITE SEVERAL reports1-7 that the early postoperative administration of enteral diets enriched with arginine, ω3 fatty acids, and nucleotides resulted in improved host defense mechanisms, the effectiveness of postoperative immunonutrition in terms of clinical benefit is a matter of debate.1,7-18 This is probably because the amount of substrates delivered in the first days after operation may not be sufficient to stimulate a prompt burst of the immune response. In fact, in patients fed supplemented formulas, the up-regulation of the immune system becomes evident only some days after operation, while the impairment of the host defense mechanisms occurs immediately after major surgery.2-5