Effects of preoperative immunonutrition vs standard oral nutrition in patients undergoing colorectal surgery: A randomized controlled trial.

Background: Current guidelines recommend providing malnourished individuals immunonutrition before major gastrointestinal surgery. Nonetheless, the advantages of preoperative immunonutrition remain controversial.

Aim: To analyses the effects of preoperative immunonutrition and standard oral nutrition supplements on colorectal surgery outcomes.

Methods: This study employed a prospective single-center randomized double-blinded comparative approach and was conducted at Hospital Universiti Sains Malaysia between September 2023 and September 2024. In this study, the participants in the experimental group were supplied with a specialized oral supplement enriched with immune-modulating nutrients. Meanwhile, a conventional oral nutrition supplement was provided to the control group. The time to first flatus and the time to first bowel evacuation were the primary outcomes recorded. Incidence of nosocomial infections, surgical site infections, and the total length of hospital stay were considered secondary data.

Results: This study involved 58 patients who were allocated into two groups. No dropouts were documented. The mean age of the participants was 61.20 ± 12.96, and most were males (63.38%). All participants' baseline and surgical characteristics in both arms were also generally comparable. The participants in this study underwent colorectal surgery, where most had laparoscopic surgery (58%). Based on the results, no significant statistical differences were observed regarding the duration from the first flatus to the first bowel evacuation, the onset of a normal diet, and hospital stay between the experimental and control groups. Both groups also recorded 10 (17.24%) infectious complications.

Conclusion: The findings indicated no notable variations in the primary and secondary endpoints despite the theoretical benefits of immune-modulating nutrients. Conclusively, routine preoperative immunonutrition may not provide additional advantages over standard nutrition in this demographic.