Abstract
To assess the effect of preoperative immunonutrition versus a standard oral nutritional supplement (ONS) in patients at nutritional risk undergoing elective liver surgery within an ERAS pathway. In the contest of the IMMUNO-ERAS study, a post-hoc analysis was conducted in the subgroup of patients at medium-high nutritional risk (MUST≥1). This study is an RCT with two parallel treatment groups receiving either ONS enriched with immunonutrients (IMN group, 50 pts) or isocaloric-isonitrogenous ONS (control group, 50 pts) for 7 days before liver resection within an ERAS pathway. The primary outcome was to evaluate in intention-to-treat analysis the length of postoperative hospital stay. The secondary outcomes were the 30-day postoperative complications and readmission, and compliance with treatment. The subgroup of patients with MUST≥1 consisted of 21 patients (10 IMN group and 11 control group). The two groups were homogeneous for preoperative and surgical characteristics, and adherence to the ERAS protocol on average high in both groups. Patients in the IMN group showed a lower median length of postoperative hospital stay, lower total and infective complications, althoug not significantly different (Table 1). Kaplan-Meier curve showed that most patients had a length of postoperative hospital stay of no more than 1 week (Figure 1). In the context of the ERAS pathway, preoperative immunonutrition could bring additional benefits at patients at nutritional risk undergoing liver surgery compared to a standard ONS. Further studies are needed in this group of patients.
Published Version
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