Preoperative immunonutrition for esophageal cancer

Introduction. Preoperative malnutrition is a demonstrated risk factor for adverse outcomes after esophagectomy. Optimizing patients' nutritional and immunological status may have beneficial impact. Objective. The aim of the present study was to evaluate the impact of preoperative oral immunonutrition (IN) on postoperative outcomes after oncological esophagectomy. Methods. Retrospective single-centre study of consecutive patients operated for esophageal cancer between 2011-2015. IN was introduced in our institution in 2013 and was given 7 days preoperatively. IN patients were compared to a control group in terms of postoperative complications, mortality and length of stay. Results. Thirty-eight IN patients were compared to 38 control patients, with comparable baseline characteristics. Seven (19%) and 11 (31%) patients were malnourished preoperatively in IN and control groups respectively (P = 0.209). Overall complication rate was 74% in the IN group and 68% in the control group (P = 0.801). Major complications occurred in 13 patients (34%) in the IN versus 8 patients (21%) in the control group (P = 0.192) and there was no significant difference in terms of mortality (respectively 11 vs. 3%, P = 0.358). Median length of stay was significantly higher in the IN group (24 days, IQR 14-53) than in controls (16 days, IQR 12-23, P = 0.034). Conclusion. A positive impact of IN on postoperative outcomes after oncological esophagectomy could not be measured. (C) 2018 Association pour le developpement de la recherche en nutrition (ADREN). Published by Elsevier Masson SAS. All rights reserved.