Perioperative nutritional support in patients undergoing gastrointestinal surgery: Current views with an emphasis on prehabilitation efforts

Continuously increasing reports in the international medical literature, along with current guidelines from international societies, support the view that perioperative enteral nutrition (EN) and immunonutrition offer significant benefits to patients with benign and/or malignant digestive disorders, including reduction of postoperative infections and hospital stay. A vital component of the rehabilitation of patients after major gastrointestinal surgery is a comprehensive nutritional rehabilitation program. It has been shown that implementing an integrated nutritional support program significantly improves patients’ immune responses, accelerates wound healing processes, reduces pain and accompanying anxiety, and decreases hospital length of stay. It appears that, in addition to the efforts of rehabilitation, prehabilitation, i.e. the return to the presurgery level of physical fitness, is or should be a vital objective of the team responsible for rehabilitating patients undergoing gastrointestinal surgery. The present review summarized the most up-to-date data on the role of perioperative nutritional support (EN and immune EN) in the rehabilitation and prehabilitation of patients undergoing major digestive surgery. Systematic and comprehensive perioperative nutritional support for these patients should become a daily clinical practice element of paramount importance.