Immunonutrition, surgery and oncology: an evidence-based model of nutritional care

Background: The present literature review allows us to propose a model of action for the timely identification of patients who require major surgery and who may benefit from nutritional interventions such as immunonutrition based on scientific evidence. Objective: The purpose of this review and synthesis is to propose a nutritional intervention model in the nutritional management of perioperative patients. Material and methods: A quick review of the literature was carried out, based on consultation of the following data sources, EMBASE, MEDLINE (Pubmed), Cochrane Database of Systematic Reviews (Wiley), LILACS (BVS, iAHx interface) and the Google Scholar search engine. Results: As a result, 40 articles were identified, which met the parameters established for the systematic review and the quality criteria, which allowed establishing four phases for the proposal of nutritional intervention 360 in perioperative nutritional management, routine nutritional screening in outpatient clinic, preoperative supplementation with therapeutic doses of immunonutrition, in-hospital nutritional intervention and postoperative nutritional follow-up. Conclusion: A nutritional intervention model that includes a nutritional contribution with a formula of amino acids (arginine and/or glutamine), polyunsaturated fatty acids (omega-3 fatty acid) and a mixture of nucleotides or RNA, is a cost-effective strategy in elective surgery patients for gastrointestinal cancer (stomach and colon cancer), head and neck surgery, patients over 18 years of age.