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The Role of the Enteral Route and the Composition of Feeds in the Nutritional Support of Malnourished Surgical Patients

Department of Surgery, Milano-Bicocca University, San Gerardo Hospital, Monza, 20900, Italy
Author to whom correspondence should be addressed.
Nutrients 2012, 4(9), 1230-1236;
Received: 24 July 2012 / Revised: 21 August 2012 / Accepted: 27 August 2012 / Published: 5 September 2012
(This article belongs to the Special Issue Enteral Nutrition)
PDF [281 KB, uploaded 5 September 2012]


In surgical patients, malnutrition is an important risk factor for post-operative complications. In undernourished patients undergoing major gastrointestinal procedures, preoperative enteral nutrition (EN) should be preferred whenever feasible. It may be given either orally or by feeding tubes, depending on patient compliance. Early oral intake after surgery should be encouraged, but if an insufficient postoperative oral intake is anticipated, tube feeding should be initiated as soon as possible. The use of immunomodulating formulas offers significant advantages when compared to standard feeds and the positive results on postoperative complications seem independent from the baseline nutritional status. In malnourished patients, the optimal timing and dose of immunonutrition is unclear, but consistent data suggest that they should be treated peri-operatively for at least two weeks. View Full-Text
Keywords: malnutrition; enteral nutrition; immunonutrition; surgery malnutrition; enteral nutrition; immunonutrition; surgery
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Nespoli, L.; Coppola, S.; Gianotti, L. The Role of the Enteral Route and the Composition of Feeds in the Nutritional Support of Malnourished Surgical Patients. Nutrients 2012, 4, 1230-1236.

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