Perioperative nutrition in colon and rectal cancer surgery

Objective: The purpose of the present review is to outline recent findings on the indications/or, and efficacy of, perioperative nutrition in patients with colon or rectal cancer. Methods: A critical analysis was made of the randomized controlled trials and meta-analyses focused on perioperative nutrition in colon and rectal cancer surgery, including the current guidelines from the European and American professional societies. Results: The preoperative use of immunonutrients improved postoperative outcomes in terms of infection rate and length of stay, both in well-nourished and undernourished patients. Contrasting results regarding reduction of infectious complications and bacterial translocation are reported for the preoperative use of probiotics. Postoperative artificial support is indicated only in patients who are not able to meet their caloric requirements orally within 7 days and in patients with postoperative complications impairing gastrointestinal function. In these patients, enteral feeding or a combination of enteral and parenteral feeding is indicated. In cases of prolonged gastrointestinal failure, parenteral nutrition is life-saving. Conclusion: There are very few indications for standard postoperative artificial nutrition in colon and rectal cancer patients with a fully functioning gastrointestinal tract. Perioperative nutrition should be reserved for malnourished patients. (Nutritional Therapy & Metabolism 2009; 27: 83-8). © SINPE-GASAPE.