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Volume 14
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10.3390/jcm14124226
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Does the Use of Oral Nutritional Supplements Influence the Rate of Postoperative Complications After Uniportal Video-Assisted Thoracoscopic Lung Resection?

by
Marco Andolfi
1,*,
Michela Tiberi
1,
Michele Salati
1,
Marina Taus
2,
Nadia Campelli
2,
Francesco Xiumè
1,
Alberto Roncon
1,
Gian Marco Guiducci
1,
Anna Chiara Nanto
1,
Claudia Cola
2,
Loris Angeli Temperoni
2 and
Majed Refai
1
1
Thoracic Surgery Unit, AOU of Marche, 60126 Ancona, Italy
2
Dietetic and Clinical Nutrition Unit, AOU of Marche, 60126 Ancona, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(12), 4226; https://doi.org/10.3390/jcm14124226 (registering DOI)
Submission received: 30 April 2025 / Revised: 31 May 2025 / Accepted: 3 June 2025 / Published: 13 June 2025
(This article belongs to the Special Issue Thoracic Surgery: State of the Art and Future Directions)
Versions Notes

Abstract

Background: The positive effects of oral nutritional supplements (ONS) on postoperative outcomes have been well recognized in several previous studies. However, to date, little data has been available with respect to determining the best immune modulating supplement to use and what its impact might be in thoracic surgery. The aim of this study was to evaluate the role of preoperative immune-nutritional supplement intake as predictor of postoperative cardiopulmonary complications (CPCs) in patients undergoing uniportal video-assisted thoracoscopic (uVATS) lung resection. Methods: This is a retrospective, observational study enrolling consecutive patients who underwent uVATS lung resections for cancer from January 2022 to December 2024 in the context of the Enhanced Pathway of Care (EPC) Program. All patients were evaluated by a nutritionist and dietetics team during the preoperative phase. The nutritional protocol consisted of 250 mL ONS rich in arginine, omega-3-fatty acids, and nucleotides to be taken twice a day for 5–7 days before surgery. Results: Four hundred ninety-one patients were enrolled: 277 patients underwent anatomic lung resection and 214 underwent wedge resection (WR). Utilizing the univariate analysis, we found that in patients undergoing anatomic lung resection, not-ONS-intake, high Body Mass Index (BMI), and arrythmia were correlated with a higher CPCs rate compared to the patients without nutritional supplementation (7.2% ONS vs. 15% not-ONS, p = 0.04; BMI 28.4 Kg/m2 vs. BMI 26.4 Kg/m2, p = 0.03; 31.2% arrythmia vs. 9.4% no-arrythmia, p < 0.01). These correlations, except for BMI, were confirmed after stepwise logistic regression. Alternately, in patients undergoing WR, hypertension and low-FEV1% were associated with a higher CPCs rate (5.1% hypertension vs. 0.4% no-hypertension, p = 0.02; FEV1% 79.7% vs. 95%, p = 0.01). Conclusions: Our results demonstrated that preoperative ONS after uVATS anatomic lung resection, in the context of an EPC program, influences the postoperative period, reducing the CPCs rate.
Keywords: uniportal video-assisted thoracoscopic surgery (uVATS); oral nutritional supplement; minimally invasive surgery; postoperative complications; ERAS uniportal video-assisted thoracoscopic surgery (uVATS); oral nutritional supplement; minimally invasive surgery; postoperative complications; ERAS

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MDPI and ACS Style

Andolfi, M.; Tiberi, M.; Salati, M.; Taus, M.; Campelli, N.; Xiumè, F.; Roncon, A.; Guiducci, G.M.; Nanto, A.C.; Cola, C.; et al. Does the Use of Oral Nutritional Supplements Influence the Rate of Postoperative Complications After Uniportal Video-Assisted Thoracoscopic Lung Resection? J. Clin. Med. 2025, 14, 4226. https://doi.org/10.3390/jcm14124226

AMA Style

Andolfi M, Tiberi M, Salati M, Taus M, Campelli N, Xiumè F, Roncon A, Guiducci GM, Nanto AC, Cola C, et al. Does the Use of Oral Nutritional Supplements Influence the Rate of Postoperative Complications After Uniportal Video-Assisted Thoracoscopic Lung Resection? Journal of Clinical Medicine. 2025; 14(12):4226. https://doi.org/10.3390/jcm14124226

Chicago/Turabian Style

Andolfi, Marco, Michela Tiberi, Michele Salati, Marina Taus, Nadia Campelli, Francesco Xiumè, Alberto Roncon, Gian Marco Guiducci, Anna Chiara Nanto, Claudia Cola, and et al. 2025. "Does the Use of Oral Nutritional Supplements Influence the Rate of Postoperative Complications After Uniportal Video-Assisted Thoracoscopic Lung Resection?" Journal of Clinical Medicine 14, no. 12: 4226. https://doi.org/10.3390/jcm14124226

APA Style

Andolfi, M., Tiberi, M., Salati, M., Taus, M., Campelli, N., Xiumè, F., Roncon, A., Guiducci, G. M., Nanto, A. C., Cola, C., Angeli Temperoni, L., & Refai, M. (2025). Does the Use of Oral Nutritional Supplements Influence the Rate of Postoperative Complications After Uniportal Video-Assisted Thoracoscopic Lung Resection? Journal of Clinical Medicine, 14(12), 4226. https://doi.org/10.3390/jcm14124226

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